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Sample records for psa screening rates

  1. Multiparametric MRI in the PSA Screening Era

    Directory of Open Access Journals (Sweden)

    Arvin K. George

    2014-01-01

    Full Text Available Prostate cancer remains significant public health concern amid growing controversies regarding prostate specific antigen (PSA based screening. The utility of PSA has been brought into question, and alternative measures are investigated to remedy the overdetection of indolent disease and safeguard patients from the potential harms resulting from an elevated PSA. Multiparametric MRI of the prostate has shown promise in identifying patients at risk for clinically significant disease but its role within the current diagnostic and treatment paradigm remains in question. The current review focuses on recent applications of MRI in this pathway.

  2. Screen for Life: Meryl Streep PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2013-05-16

    In this 30 second PSA, Academy Award®-winning actress Meryl Streep urges viewers to get screened for colorectal cancer.  Created: 5/16/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/16/2013.

  3. Screen for Life: Meryl Streep PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-05-16

    In this 60 second PSA, Academy Award®-winning actress Meryl Streep urges viewers to get screened for colorectal cancer.  Created: 5/16/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/16/2013.

  4. Doctors' perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: a qualitative study.

    Science.gov (United States)

    Pickles, Kristen; Carter, Stacy M; Rychetnik, Lucie; Entwistle, Vikki A

    2016-12-05

    To examine how general practitioners (GPs) in the UK and GPs in Australia explain their prostate-specific antigen (PSA) testing practices and to illuminate how these explanations are similar and how they are different. A grounded theory study. Primary care practices in Australia and the UK. 69 GPs in Australia (n=40) and the UK (n=29). We included GPs of varying ages, sex, clinical experience and patient populations. All GPs interested in participating in the study were included. GPs' accounts revealed fundamental differences in whether and how prostate cancer screening occurred in their practice and in the broader context within which they operate. The history of prostate screening policy, organisational structures and funding models appeared to drive more prostate screening in Australia and less in the UK. In Australia, screening processes and decisions were mostly at the discretion of individual clinicians, and varied considerably, whereas the accounts of UK GPs clearly reflected a consistent, organisationally embedded approach based on local evidence-based recommendations to discourage screening. The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia's recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will need to be addressed. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  5. Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

    NARCIS (Netherlands)

    Rybalov, Maxim; Breeuwsma, Anthonius J.; Leliveld, Anna M.; Pruim, Jan; Dierckx, Rudi A.; de Jong, Igle J.

    PURPOSE: To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of (11)C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT). METHODS: We included 185 patients with BCR after RP (PSA >0.2 ng/ml)

  6. Alcohol Screening and Counseling PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2014-01-07

    This 60 second public service announcement is based on the January 2014 CDC Vital Signs report. Millions of Americans drink too much, a dangerous behavior that can lead to serious health problems. Alcohol screening and counseling can help.  Created: 1/7/2014 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/7/2014.

  7. PSA screening for prostate cancer: why so much controversy?

    Science.gov (United States)

    Labrie, Fernand

    2013-09-01

    Since prostate cancer reaches the advanced and non curable stage in the absence of any specific symptom or sign, it seems reasonable to diagnose this cancer at an early and curable stage. Screening by prostate-specific antigen (PSA) has been the common technology used. The last follow-up of the first two prospective and randomized screening studies for prostate cancer, namely the Quebec and ERSPC (European Randomized Study of Screening for Prostate Cancer) clinical trials started in 1988 and 1991, respectively, have shown reductions of prostate cancer death of 62% (PProstate Lung Colorectal and Ovarian Cancer) screening trial reported no benefit. It has been estimated, however, that 85% of men in the planned 'non-screened' group of the US study have been screened. With such a serious flaw, the PLCO study does not have the statistical power to reach any valid conclusion. In the Quebec study, only 7.3% of men were screened in the control arm. The important benefit observed in the ERSPC study was achieved using a less than optimal 4-year PSA screening interval which misses a significant number of cancers while the Quebec study used the optimal 1-year interval. With proper information obtained from their physicians or otherwise using data collected only from the clinical trials having the required statistical power, men should be in a good position to decide about being or not being screened for prostate cancer.

  8. Prognostic Significance of Prostate-Specific Antigen (PSA) Rate of ...

    African Journals Online (AJOL)

    Aim: To investigate the prognostic significance of Prostate-Specific Antigen (PSA) rate of change in patients with advanced prostate cancer . Patients and Methods: A total of forty-nine male patients aged between 42 and 84 years with advanced prostate cancer receiving therapy of maximum androgen bloackade were ...

  9. Influence of metformin use on PSA values, free-to-total PSA, prostate cancer incidence and grade and overall survival in a prospective screening trial (ERSPC Aarau).

    Science.gov (United States)

    Randazzo, Marco; Beatrice, Josef; Huber, Andreas; Grobholz, Rainer; Manka, Lukas; Wyler, Stephen F; Chun, Felix F; Recker, Franz; Kwiatkowski, Maciej

    2015-08-01

    To analyze the effect of the oral antidiabetic drug metformin on PSA level, free-to-total PSA ratio (f/t-ratio), PCa incidence and grade as well as mortality in men participating in a population-based screening trial. Data from 4,314 men aged 55-70 years from a population-based PSA-screening trial (ERSPC Aarau) were analyzed. Information on metformin exposure was obtained by a self-administered questionnaire. Serum PSA threshold at ≥3 ng/ml triggered prostate biopsy. Data on PCa incidence and mortality were obtained through registry linkages. Median follow-up time was 7.6 years. Mean age at baseline was 65.5 years (±SD 4.4). In all, n = 150 (3.5 %) men used metformin [metf+]. Mean baseline PSA levels were comparable between both groups ([metf+] 1.6 ng/ml ± 2.4 vs. [metf-] 1.8ug/l ± 2.2, p = 0.4) while f/t-ratio was slightly higher in metformin users ([metf+] 30.7 % ± 10.9 vs. [metf-] 27.3 % ± 10.9, p = 0.01). Overall, n = 372 (8.6 %) PCa cases were detected. Neither cumulative PCa incidence (n = 11; 7.3 % [metf+] vs. n = 361 8.7 % [metf-]; p = 0.5) nor d`Amico risk groups were significantly different between both groups. One man in each group (metf+ 0.7 % and metf- 0.02 %) died from PCa (p incidence and grade were observed. The slightly higher f/t-ratio did not result in lower PCa detection rate. Metformin users were at significantly higher risk of all-cause mortality. The relatively small number of men on metformin is a main limitation of the study.

  10. Prostate Cancer Screening: Should You Get a PSA Test?

    Science.gov (United States)

    ... PSA test result turns out to have prostate cancer. Some prostate cancers, particularly those that grow quickly, may not ... and prevention. Cancer.Net. http://www.cancer.net/cancer-types/prostate-cancer/risk-factors-and-prevention. Accessed Aug. 2, ...

  11. Metastatic Prostate Cancer Diagnosed by Bone Marrow Aspiration in an Elderly Man Not Undergoing PSA Screening

    Directory of Open Access Journals (Sweden)

    Ridwan Alam

    2017-02-01

    Full Text Available Prostate cancer screening by PSA testing remains controversial, particularly in the elderly. Practice guidelines from most clinical societies suggest discontinuing PSA screening at age 70 while the USPSTF recommends against screening at any age. Recent reports have demonstrated an increased incidence of metastatic prostate cancer, with men aged 75 or older accounting for roughly half of those newly diagnosed at an incurable stage. We herein describe the case of an elderly gentleman with no history of prostate cancer screening who presented with anorexia and back pain of unclear etiology. Evaluation with bone marrow aspiration revealed a diagnosis of metastatic prostate cancer.

  12. Applying strategies from libertarian paternalism to decision making for prostate specific antigen (PSA screening

    Directory of Open Access Journals (Sweden)

    Black Amanda

    2011-04-01

    Full Text Available Abstract Background Despite the recent publication of results from two randomized clinical trials, prostate specific antigen (PSA screening for prostate cancer remains a controversial issue. There is lack of agreement across studies that PSA screening significantly reduces prostate cancer mortality. In spite of these facts, the widespread use of PSA testing in the United States leads to overdetection and overtreatment of clinically indolent prostate cancer, and its associated harms of incontinence and impotence. Discussion Given the inconclusive results from clinical trials and incongruent PSA screening guidelines, the decision to screen for prostate cancer with PSA testing is an uncertain one for patients and health care providers. Screening guidelines from some health organizations recommend an informed decision making (IDM or shared decision making (SDM approach for deciding on PSA screening. These approaches aim to empower patients to choose among the available options by making them active participants in the decision making process. By increasing involvement of patients in the clinical decision-making process, IDM/SDM places more of the responsibility for a complex decision on the patient. Research suggests, however, that patients are not well-informed of the harms and benefits associated with prostate cancer screening and are also subject to an assortment of biases, emotion, fears, and irrational thought that interferes with making an informed decision. In response, the IDM/SDM approaches can be augmented with strategies from the philosophy of libertarian paternalism (LP to improve decision making. LP uses the insights of behavioural economics to help people better make better choices. Some of the main strategies of LP applicable to PSA decision making are a default decision rule, framing of decision aids, and timing of the decision. In this paper, we propose that applying strategies from libertarian paternalism can help with PSA

  13. Deciding on PSA-screening - Quality of current consumer information on the Internet.

    Science.gov (United States)

    Korfage, Ida J; van den Bergh, Roderick C N; Essink-Bot, Marie-Louise

    2010-11-01

    Given that screening for prostate cancer has the potential to reduce prostate cancer mortality at the expense of considerable overdiagnosis and overtreatment, the availability of core consumer information - correct, balanced and supportive of autonomous decision-making - is a must. We assessed the quality of consumer information available through the Internet per November 2009 and its possible contribution to informed decision-making by potential screenees. Consumer information on PSA-screening was sought through the Internet in November 2009. Materials had to be targeted at potential consumers, offered by not-for-profit organisations, released in 2005 or after, in English or Dutch. Per material 2 of the authors assessed independently from each other whether standardised pre-defined topics were addressed, whether the content was correct and which approach was taken towards the decision-making process about uptake. Twenty-three materials were included, of which 11 were released (shortly) after the results of 2 large randomized-controlled trials (RCTs) that evaluated the effectiveness of screening for prostate cancer had been published in March 2009. That a PSA-test result can be abnormal because of non-cancerous conditions (false positive) and that it may miss prostate cancer (false negative) was not addressed in 2/23 and 8/23 materials, respectively. The risk of overdiagnosis and overtreatment was not mentioned in 6 out of 23. PSA-screening was presented as a usual thing to do in some materials, whereas other materials emphasised the voluntary nature of PSA-screening ('it is your decision'). The content of 19/23 materials was considered sufficiently informative according to the pre-defined criteria, 12/23 materials were considered supportive of informed decision-making by men. Most materials of not-for-profit organizations supplied adequate information about PSA-screening, whilst the degree of persuasion towards uptake reflected variations in opinions on men

  14. Evaluating the Impact of PSA as a Selection Criteria for Nerve Sparing Radical Prostatectomy in a Screened Cohort

    Directory of Open Access Journals (Sweden)

    Shyam K. Tanguturi

    2014-01-01

    Full Text Available Purpose. We investigated whether NS-RP increased risk of PSA failure and whether PSA should be included as a selection criterion for NS. Methods. We evaluated 357 consecutive men with screen-detected PC who underwent open RP without adjuvant radiotherapy between 9/11/2001 and 12/30/2008. Criteria for NS included Gleason score ≤3 + 4, percentage of positive biopsies (PPB ≤50%, percentage of core involvement ≤50%, nonapical location, no perineural invasion, and no palpable disease on pre- or intraoperative exam but did not include a PSA threshold. Cox multivariable regression assessed whether increasing PSA or unilateral- or bilateral-NS versus non-NS-RP was associated with PSA failure adjusting for prognostic factors. Results. After a median follow-up of 3.96 years, 34 men sustained PSA failure (9.5%. Increasing PSA was significantly associated with increased risk of PSA failure in the interaction model (adjusted hazard ratio (AHR: 1.09 [95% CI: 1.03–1.16]; P=0.005, whereas unilateral (AHR: 1.24 [95% CI: 0.36–4.34]; P=0.73 or bilateral NS (AHR: 0.41 [95% CI: 0.06–2.59]; P=0.34 versus non-NS RP was not. Conclusion. NS-RP in a screened cohort did not increase risk of PSA failure using NS criteria not including PSA.

  15. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  16. Message from Terrence Howard: Screening for Colorectal Cancer PSA (:20)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message from the actor/musician Terrence Howard about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  17. Influence of trigger PSA and PSA kinetics on 11C-Choline PET/CT detection rate in patients with biochemical relapse after radical prostatectomy.

    Science.gov (United States)

    Castellucci, Paolo; Fuccio, Chiara; Nanni, Cristina; Santi, Ivan; Rizzello, Anna; Lodi, Filippo; Franceschelli, Alessandro; Martorana, Giuseppe; Manferrari, Fabio; Fanti, Stefano

    2009-09-01

    The purpose of this study was to investigate the effect of total prostate-specific antigen (PSA) at the time of (11)C-choline PET/CT (trigger PSA), PSA velocity (PSAvel), and PSA doubling time (PSAdt) on (11)C-choline PET/CT detection rate in patients treated with radical prostatectomy for prostate cancer, who showed biochemical failure during follow-up. A total of 190 patients treated with radical prostatectomy for prostate cancer who showed an increase in PSA (mean, 4.2; median, 2.1; range, 0.2-25.4 ng/mL) were retrospectively enrolled. All patients were studied with (11)C-choline PET/CT. Patients were grouped according to trigger PSA (PSA 5 ng/mL). In 106 patients, data were available for calculation of PSAvel and PSAdt. Logistic regression analysis was used to determine whether there was a relationship between PSA levels and PSA kinetics and the rate of detection of relapse using PET. (11)C-choline PET/CT detected disease relapse in 74 of 190 patients (38.9%). The detection rate of (11)C-choline PET/CT was 19%, 25%, 41%, and 67% in the 4 subgroups-PSA 5 ng/mL (49 patients)-respectively. Trigger PSA values were statistically different between PET-positive patients (median PSA, 4.0 ng/mL) and PET-negative patients (median PSA, 1.4 ng/mL) (P = 0.0001). Receiver-operating-characteristic analysis showed an optimal cutoff point for trigger PSA of 2.43 ng/mL (area under the curve, 0.76). In 106 patients, PSAdt and PSAvel values were statistically different between patients with PET-positive and -negative scan findings (P = 0.04 and P = 0.03). The (11)C-choline PET/CT detection rate was 12%, 34%, 42%, and 70%, respectively, in patients with PSAvel 5 ng/mL/y (28 patients). The (11)C-choline PET/CT detection rate was 20%, 40%, 48%, and 60%, respectively, in patients with PSAdt > 6 mo (45 patients), 4 < PSAdt

  18. Predictive simulations and optimization of nanowire field-effect PSA sensors including screening

    KAUST Repository

    Baumgartner, Stefan

    2013-05-03

    We apply our self-consistent PDE model for the electrical response of field-effect sensors to the 3D simulation of nanowire PSA (prostate-specific antigen) sensors. The charge concentration in the biofunctionalized boundary layer at the semiconductor-electrolyte interface is calculated using the propka algorithm, and the screening of the biomolecules by the free ions in the liquid is modeled by a sensitivity factor. This comprehensive approach yields excellent agreement with experimental current-voltage characteristics without any fitting parameters. Having verified the numerical model in this manner, we study the sensitivity of nanowire PSA sensors by changing device parameters, making it possible to optimize the devices and revealing the attributes of the optimal field-effect sensor. © 2013 IOP Publishing Ltd.

  19. PSA-Based Screening Outcomes, Dietary Heterocyclic Amine Exposure, and Prostate Cancer Risk in African Americans: Annual Report (Year 1 of 3)

    Energy Technology Data Exchange (ETDEWEB)

    Bogen, K T

    2006-01-18

    Prostate cancer (PC) is the second leading cause of male U.S. cancer deaths, with African-Americans having the highest rate of PC mortality worldwide, as well as more abnormal results from screening tests that correlate with current or eventual PC. A 3-year prospective clinic-based study is studying the performance of current (PSA and DRE) vs. (% free PSA) clinical biomarkers of PC risk in 400 African-American men 50 to 70 years of age who undergo PC screening in Oakland, CA (East Bay San Francisco area), as well as possible association of PC screening results for these men with their dietary exposures to the cancer-causing heterocyclic amine, 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP) that forms when meat is cooked. This study expands an ongoing NIH-funded study (by the same research team) to add a new %-free-PSA test, results of which will be compared with PSA/DRE results and PhIP exposures estimated by dietary interviews. For 392 men studied under the NIH protocol, an odds ratio (95% CL) of 32 (3.2, 720) for highly elevated PSA ({ge}20 ng/mL) was observed in the highest 15% vs. the lower 50% of estimated daily PhIP intakes. Approximately 100 additional men have completed participation in the expanded NIH/DOD-supported study. This study will help define the potential value of improved screening and dietary/behavioral intervention to reduce PC risk, namely, prevention of PhIP intake by avoiding overcooked meats.

  20. Prostate cancer screening by prostate-specific antigen (PSA); a relevant approach for the small population of the Cayman Islands.

    Science.gov (United States)

    Jyoti, Shravana Kumar; Blacke, Camille; Patil, Pallavi; Amblihalli, Vibha P; Nicholson, Amanda

    2018-01-01

    The common tool for diagnosing prostate cancer is prostate-specific antigen (PSA), but the high sensitivity and low specificity of PSA testing are the problems in clinical practice. There are no proper guidelines to investigate the suspected prostate cancer in the Cayman Islands. We correlated PSA levels with the incidence of prostate cancers by tissue diagnosis and proposed logical protocol for prostate screening by using PSA test in this small population. A total of 165 Afro Caribbean individuals who had prostate biopsy done after the investigations for PSA levels from year 2005 to 2015 were studied retrospectively. The patients were divided into subgroups by baseline PSA levels as follows: 100 ng/mL and were correlated to the age and presence of cancer. Benign lesions had lower PSA levels compared to cancer which generally had higher values. Only three cases that had less than 4 ng/mg were turned out to be malignant. When PSA value was more than 100 ng/mL, all the cases were malignant. Between PSA values of 4-100 ng/mL, the probability of cancer diagnosis was 56.71% (76 cancers out of 134 in this range). Limitation of PSA testing has the risk of over diagnosis and the resultant negative biopsies owing to poor specificity. Whereas the cutoff limit for cancer diagnosis still remains 4 ng/mL from our study, most of the patients can be assured of benign lesion below this level and thus morbidity associated with the biopsy can be prevented. When the PSA value is greater than 100 ng, biopsy procedure was mandatory as there were 100% cancers above this level. On the background of vast literature linking PSA to prostate cancer and its difficulty in implementing in clinical practice, we studied literature of this conflicting and complex topic and tried to bring relevant protocols to the small population of Cayman Islands for the screening of prostate cancer. In this study, a total of 165 Afro Caribbean individuals who had prostate biopsy done after the

  1. Many young men with prostate-specific antigen (PSA) screen-detected prostate cancers may be candidates for active surveillance

    Science.gov (United States)

    Kim, Jeri; Ebertowski, James; Janiga, Matthew; Arzola, Jorge; Gillespie, Gayle; Fountain, Michael; Soderdahl, Douglas; Canby-Hagino, Edith; Elsamanoudi, Sally; Gurski, Jennifer; Davis, John W.; Parker, Patricia A.; Boyd, Douglas D.

    2012-01-01

    SUMMARY Objective To identify a population of young men (aged 30-fold. Data for a subset of men (174) with PSA screen-detected cancer were evaluable for disease risk assessment. Of the 174 men with screen-detected disease, 81 (47%) had very-low-risk disease. Of that group, 96% (78/81) selected treatment and, of 57 men undergoing radical prostatectomy (RP), the tumours of 49 (86%) carried favourable pathology (organ confined, < 10% gland involvement, Gleason ≤ 6). Conclusions Nearly half of young men with PSA screen-detected prostate cancer are AS candidates but the overwhelming majority seek treatment. Considering that many tumours show favourable pathology at RP, there is a possibility that these patients may benefit from AS management. PMID:23350937

  2. Histological inflammation and risk of subsequent prostate cancer among men with initially elevated serum prostate-specific antigen (PSA) concentration in the Finnish prostate cancer screening trial.

    Science.gov (United States)

    Yli-Hemminki, Tytti H; Laurila, Marita; Auvinen, Anssi; Määttänen, Liisa; Huhtala, Heini; Tammela, Teuvo L J; Kujala, Paula M

    2013-10-01

    To assess whether histological signs of inflammation are associated with an increased risk of subsequent prostate cancer (PCa) in men with elevated serum prostate-specific antigen (PSA) concentrations and benign initial biopsy. Study subjects were men aged 54-67 years with an elevated PSA (≥4 ng/mL or 3-4 ng/mL and free to total PSA ratio ≤0.16 or positive digital rectal examination), but a benign biopsy result within the Finnish population-based randomised screening trial for PCa, which started in 1996. A total of 293 prostate biopsies without PCa or suspicion of malignancy from the first screening round in the Tampere centre were re-evaluated by a uropathologist to assess histological inflammation. Results of the subsequent screening rounds were obtained from the trial database and PCa diagnoses made outside the screening were obtained from the Finnish Cancer Registry. The median length of follow-up was 10.5 years. Cox regression analysis was used to assess PCa risk after the initial benign biopsy. Histological inflammation was found in 66% of the biopsies. Subjects with inflammation at the biopsy had a slightly lower PCa risk in the second screening round (18 vs 27%, rate ratio 0.69, 95% confidence interval [CI] 0.35-1.34) relative to men without inflammation. In further follow-up, the PCa risk remained nonsignificantly lower (hazard ratio [HR] 0.71, CI 0.46-1.10; P = 0.13). The risk was not appreciably affected by adjustment for age, PSA, prostate volume and family history of PCa (HR 0.67, CI 0.42-1.07; P = 0.092). Histological inflammation in a prostate biopsy among men with an initial false-positive screening test was not associated with an increased risk of subsequent PCa, but instead with a decreased risk which was of borderline significance. Inflammation in prostate biopsy is not a useful risk indicator in PCa screening. © 2013 BJU International.

  3. Prostate-Specific Antigen (PSA) Test

    Science.gov (United States)

    ... Genetics of Prostate Cancer Prostate Cancer Screening Research Prostate-Specific Antigen (PSA) Test On This Page What ... the PSA test for prostate cancer screening? Detecting prostate cancer early may not reduce the chance of ...

  4. Impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) on prostate-specific antigen (PSA) testing by Dutch general practitioners

    NARCIS (Netherlands)

    Van der Meer, Saskia; Kollen, Boudewijn J.; Hirdes, Willem H.; Steffens, Martijn G.; Hoekstra-Weebers, Josette E. H. M.; Nijman, Rien M.; Blanker, Marco H.

    Objective To determine the impact of the European Randomized Study of Screening for Prostate Cancer (ERSPC) publication in 2009 on prostate-specific antigen (PSA) level testing by Dutch general practitioners (GPs) in men aged 40 years. Materials and Methods Retrospective study with a Dutch insurance

  5. PSA-based prostate cancer screening: The role of active surveillance and informed and shared decision making

    NARCIS (Netherlands)

    L.D.F. Venderbos (Lionne); M.J. Roobol-Bouts (Monique)

    2011-01-01

    textabstractSince the first publication describing the identification of prostate-specific antigen (PSA) in the 1960s, much progress has been made. The PSA test changed from being initially a monitoring tool to being also used as a diagnostic tool. Over time, the test has been heavily debated due to

  6. The value of screening tests in the detection of prostate cancer. Part II: Retrospective analysis of free/total prostate-specific analysis ratio, age-specific reference ranges, and PSA density

    NARCIS (Netherlands)

    C.H. Bangma (Chris); R. Kranse (Ries); B.G. Blijenberg (Bert); F.H. Schröder (Fritz)

    1995-01-01

    textabstractObjectives: The ratio between free and total prostate-specific antigen (PSA) in serum (F/T ratio) was shown to improve the specificity of total serum PSA for the detection of prostate carcinoma in selected populations. In this study, the value of the F/T ratio for screening of prostate

  7. Can delayed time to referral to a tertiary level urologist with an abnormal PSA level affect subsequent Gleason grade in the opportunistically screened population?

    LENUS (Irish Health Repository)

    O'Kelly, Fardod

    2013-09-01

    There is growing conflict in the literature describing the effect of delayed treatment on outcomes following radical prostatectomy. There is also evidence to suggest progression of low-risk prostate cancer to develop higher grades and volumes of prostate cancer during active surveillance. It is unknown as to what affect a delay in referral of those men with abnormal screened-PSA levels have on subsequent Gleason grade.

  8. PSA kinetics after prostate brachytherapy: PSA bounce phenomenon and its implications for PSA doubling time.

    Science.gov (United States)

    Ciezki, Jay P; Reddy, Chandana A; Garcia, Jorge; Angermeier, Kenneth; Ulchaker, James; Mahadevan, Arul; Chehade, Nabil; Altman, Andrew; Klein, Eric A

    2006-02-01

    To analyze prostate-specific antigen (PSA) kinetics in patients treated with prostate brachytherapy (PI) with a minimum of 5 years of PSA follow-up. The records of 162 patients treated with PI for localized prostate cancer with a minimum of 5 years of PSA follow-up were reviewed. A variety of pretreatment and posttreatment variables were examined. Patients were coded as having a PSA bounce if their PSA achieved a nadir, elevated at least 0.2 ng/mL greater than that nadir, and decreased to, or below, the initial nadir. Two definitions of biochemical failure (bF) or biochemical relapse-free survival (bRFS) were used: the classic American Society for Therapeutic Radiology and Oncology consensus definition of three consecutive rises (bF3) and the nadir plus 2 ng/mL definition (bFn+2). Associations between a PSA bounce and the various pre- and posttreatment factors were assessed with logistic regression analysis, and the association between a PSA bounce and bF was examined with the log-rank test. The Mann-Whitney U test was applied to test for differences in the PSA doubling time (PSADT) and the time to a PSA rise between the PSA bounce patients and the bF patients. PSADT was calculated from the nadir to the time of the first PSA rise, because this point is known first in the clinical setting. The 5-year overall bRFS rate was 87% for the bF3 definition and 96% for the bFn+2 definition. A PSA bounce was experienced by 75 patients (46.3%). Patients who experienced a PSA bounce were less likely to have a bF, regardless of the bRFS definition used (bF3: p=0.0015; bFn+2: p=0.0040). Among the pre- and posttreatment factors, only younger age predicted for a PSA bounce on multivariate analysis (p=0.0018). The use of androgen deprivation had no effect on PSA bounce. No difference was found in the PSADT between patients who had a PSA bounce and those with bF. The median PSADT for those with a PSA bounce was 8.3 months vs. 10.3 months using the bF3 definition and 8.8 months using

  9. National Prostate Cancer Screening Rates After the 2012 US Preventive Services Task Force Recommendation Discouraging Prostate-Specific Antigen-Based Screening.

    Science.gov (United States)

    Drazer, Michael W; Huo, Dezheng; Eggener, Scott E

    2015-08-01

    In 2012, the US Preventive Services Task Force (USPSTF) discouraged prostate-specific antigen (PSA) -based prostate cancer screening. Previous USPSTF recommendations did not appreciably alter prostate cancer screening. Therefore, we designed a trend analysis to determine the population-based impact of the 2012 recommendation. The nationally representative National Health Interview Survey was used to estimate the proportion of men age 40 years and older who saw a physician and were screened for prostate cancer in 2013. An externally validated 9-year mortality index was used to analyze screening rates based on remaining life expectancy. Screening rates from 2005, 2010, and 2013 were compared using logistic regression. PSA-based screening did not significantly change from 2010 to 2013 among 40- to 49-year-old men (from 12.5% to 11.2%; P = .4). Screening rates significantly declined in men age 50 to 59 years (from 33.2% to 24.8%; P screened for prostate cancer despite a high risk (> 52%) of 9-year mortality, including approximately one third of men older than age 75 years. Approximately 1.4 million men age 65 years or older with a high risk (> 52%) of 9-year mortality were screened in 2013. Prostate cancer screening significantly declined among men older than age 50 years after the 2012 USPSTF guideline discouraging PSA-based screening. A significant proportion of men continue to be screened despite a high risk of 9-year mortality, including one third of men age 75 years and older. © 2015 by American Society of Clinical Oncology.

  10. [Usefulness of screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("human dock") at Onomichi Municipal Hospital: clinical significance of the cases diagnosed as prostate cancer].

    Science.gov (United States)

    Oeda, Tadashi; Kusumi, Norihiro; Takamoto, Atsushi

    2010-01-01

    The usefulness of the screening for prostate cancer with prostate specific antigen (PSA) in the medical checkup ("Human Dock") at Onomichi Municipal Hospital was evaluated. From April 1997 to December 2007, serum PSA of 1,234 male (median age: 59) was measured in the medical checkup and each parameter of screening was evaluated. In addition, for the cases with prostate cancer, results of treatment and clinical significance were assessed. PSA was elevated in 82 cases (6.6%), aged 42-87 (median 64), in which PSA varied 3.1-66.5 ng/ml (median 5.4). Trans-rectal biopsy was performed in 35 cases and prostate cancer was detected in 15 (42.9% of biopsied cases and 1.2% of whole group), aged 58-81 (median 70), with PSA value 4.2-66.5 ng/ml (median 10.3). Clinical stage of these cases was cT1cN0M0 in 12 and cT2aN0M0 or more in 3, Gleason score was 3 + 3 in 4 and 3 + 4 or more in 11. Initial treatment was radical prostatectomy in 12, androgen-deprivation therapy in 2 and external beam irradiation in 1. During the follow-up for 8-107 months (median 60), 14 were alive with good control and 1 was alive with relapse. Only one case was "clinically insignificant" cancer (impalpable and localized and tumor volume less than 0.5 ml and Gleason score 3 + 3 or less). Most of the prostate cancers detected in the medical checkup were clinically significant, therefore, PSA screening doesn't result in overtreatment and it is meaningful to perform PSA screening in the medical checkup.

  11. Prostate Specific Antigen (PSA as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT in Combination with Additional External Beam Radiation Therapy (EBRT for High Risk Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Thorsten H. Ecke

    2016-11-01

    Full Text Available High-dose-rate brachytherapy (HDR-BT with external beam radiation therapy (EBRT is a common treatment option for locally advanced prostate cancer (PCa. Seventy-nine male patients (median age 71 years, range 50 to 79 with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index, Gleason score, D’Amico risk classification for PCa, digital rectal examination (DRE, PSA value after one/three/five year(s follow-up (FU, time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009, PSA on date of first HDR-BT (p = 0.033, and PSA on date of first follow-up after one year (p = 0.025 have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  12. Prostate Specific Antigen (PSA) as Predicting Marker for Clinical Outcome and Evaluation of Early Toxicity Rate after High-Dose Rate Brachytherapy (HDR-BT) in Combination with Additional External Beam Radiation Therapy (EBRT) for High Risk Prostate Cancer.

    Science.gov (United States)

    Ecke, Thorsten H; Huang-Tiel, Hui-Juan; Golka, Klaus; Selinski, Silvia; Geis, Berit Christine; Koswig, Stephan; Bathe, Katrin; Hallmann, Steffen; Gerullis, Holger

    2016-11-10

    High-dose-rate brachytherapy (HDR-BT) with external beam radiation therapy (EBRT) is a common treatment option for locally advanced prostate cancer (PCa). Seventy-nine male patients (median age 71 years, range 50 to 79) with high-risk PCa underwent HDR-BT following EBRT between December 2009 and January 2016 with a median follow-up of 21 months. HDR-BT was administered in two treatment sessions (one week interval) with 9 Gy per fraction using a planning system and the Ir192 treatment unit GammaMed Plus iX. EBRT was performed with CT-based 3D-conformal treatment planning with a total dose administration of 50.4 Gy with 1.8 Gy per fraction and five fractions per week. Follow-up for all patients was organized one, three, and five years after radiation therapy to evaluate early and late toxicity side effects, metastases, local recurrence, and prostate-specific antigen (PSA) value measured in ng/mL. The evaluated data included age, PSA at time of diagnosis, PSA density, BMI (body mass index), Gleason score, D'Amico risk classification for PCa, digital rectal examination (DRE), PSA value after one/three/five year(s) follow-up (FU), time of follow-up, TNM classification, prostate volume, and early toxicity rates. Early toxicity rates were 8.86% for gastrointestinal, and 6.33% for genitourinary side effects. Of all treated patients, 84.81% had no side effects. All reported complications in early toxicity were grade 1. PSA density at time of diagnosis (p = 0.009), PSA on date of first HDR-BT (p = 0.033), and PSA on date of first follow-up after one year (p = 0.025) have statistical significance on a higher risk to get a local recurrence during follow-up. HDR-BT in combination with additional EBRT in the presented design for high-risk PCa results in high biochemical control rates with minimal side-effects. PSA is a negative predictive biomarker for local recurrence during follow-up. A longer follow-up is needed to assess long-term outcome and toxicities.

  13. Does Computer Screen Color Affect Reading Rate?

    Science.gov (United States)

    Clausing, Carolyn S.; Schmitt, Dorren R.

    A study investigated differences in reading rate and comprehension scores of 8th grade students on a cloze reading exercise involving the reading of a cloze passage from 10 different modes of text presentation (8 different computer screen formats and 2 different paper formats). Subjects, 300 students in computer literacy classes from 7 schools in…

  14. A Multi-Center Study of [−2]Pro-Prostate-Specific Antigen (PSA) in Combination with PSA and Free PSA for Prostate Cancer Detection in the 2.0 to 10.0 ng/mL PSA Range

    Science.gov (United States)

    Catalona, William J.; Partin, Alan W.; Sanda, Martin G.; Wei, John T.; Klee, George G.; Bangma, Chris H.; Slawin, Kevin M.; Marks, Leonard S.; Loeb, Stacy; Broyles, Dennis L.; Shin, Sanghyuk S.; Cruz, Amabelle B.; Chan, Daniel W.; Sokoll, Lori J.; Roberts, William L.; van Schaik, Ron H.N.; Mizrahi, Isaac A.

    2011-01-01

    Purpose PSA and free PSA (fPSA) have limited specificity for detecting clinically significant, curable prostate cancer (PCa), leading to unnecessary biopsies and detection and treatment of some indolent tumors. [−2]proPSA (p2PSA) may improve specificity for detecting clinically significant PCa. Our objective was to evaluate p2PSA, fPSA, and PSA in a mathematical formula (prostate health index [phi] = [−2]proPSA / fPSA) × PSA1/2) to enhance specificity for detecting overall and high-grade PCa. Materials and Methods We enrolled 892 men in a prospective multi-institutional trial with no history of PCa, normal rectal examination, a PSA of 2–10 ng/mL, and ≥6- core prostate biopsy. We examined the relationship of serum PSA, %fPSA and phi with biopsy results. The primary endpoints were the specificity and AUC using phi to detect overall and Gleason ≥7 prostate cancer on biopsy compared with %fPSA. Results For the 2–10 ng/mL PSA range, at 80–95% sensitivity, the specificity and AUC (0.703) of phi exceeded those of PSA and %fPSA. Increasing phi was associated with a 4.7-fold increased risk of PCa and 1.61-fold increased risk of Gleason ≥7 disease on biopsy. The AUC for phi (0.724) exceeded that of %fPSA (0.670) in discriminating between PCa with Gleason ≥ 4+3 vs. lower grade disease or negative biopsies. Phi results were not associated with age and prostate volume. Conclusions Phi may be useful in PCa screening to reduce unnecessary biopsies in men age ≥50 years with PSA 2–10 ng/mL and negative DRE, with minimal loss in sensitivity. PMID:21419439

  15. Clinician Factors Associated With Prostate-Specific Antigen Screening in Older Veterans With Limited Life Expectancy.

    Science.gov (United States)

    Tang, Victoria L; Shi, Ying; Fung, Kathy; Tan, Jessica; Espaldon, Roxanne; Sudore, Rebecca; Wong, Melisa L; Walter, Louise C

    2016-05-01

    Despite guidelines recommending against prostate-specific antigen (PSA) screening in elderly men with limited life expectancy, PSA screening remains common. To identify clinician characteristics associated with PSA screening rates in older veterans stratified by life expectancy. Cross-sectional study of 826 286 veterans 65 years or older eligible for PSA screening who had VA laboratory tests performed in 2011 in the VA health care system. The primary outcome was the percentage of men with a screening PSA test in 2011. Limited life expectancy was defined as age of at least 85 years with Charlson comorbidity score of 1 or greater or age of at least 65 years with Charlson comorbidity score of 4 or greater. Primary predictors were clinician characteristics including degree-training level, specialty, age, and sex. We performed log-linear Poisson regression models for the association between each clinician characteristic and PSA screening stratified by patient life expectancy and adjusted for patient demographics and clinician clustering. In 2011, 466 017 (56%) of older veterans received PSA screening, including 39% of the 203 717 men with limited life expectancy. After adjusting for patient demographics, higher PSA screening rates in patients with limited life expectancy was associated with having a clinician who was an older man and was no longer in training. The PSA screening rates ranged from 27% for men with a physician trainee to 42% for men with an attending physician (P life expectancy received PSA screening. Men whose clinician was a physician trainee had substantially lower PSA screening rates than those with an attending physician, nurse practitioner, or physician assistant. Interventions to reduce PSA screening rates in older men with limited life expectancy should be designed and targeted to high-screening clinicians- older male, nontrainee clinicians-for greatest impact.

  16. Factors prompting PSA-testing of asymptomatic men in a country with no guidelines: a national survey of general practitioners.

    LENUS (Irish Health Repository)

    Drummond, Frances J

    2009-01-01

    BACKGROUND: Increased use of prostate specific antigen (PSA) has been associated with increased prostate cancer incidence. Ireland is estimated to have one of the highest prostate cancer incidences in Europe and has no national guidelines for prostate cancer screening. GPs have a pivotal role in influencing PSA testing, therefore, our aim was to describe GP testing practices and to identify factors influencing these. METHODS: A postal survey, including questions on clinical practice and experience, knowledge and demographics was distributed to all GPs (n = 3,683). The main outcomes were (i) PSA testing asymptomatic men and (ii) "inappropriate" PSA testing, defined as testing asymptomatic men aged < 50 or > 75 years. Factors associated with these outcomes were identified using logistic regression. RESULTS: 1,625 GPs responded (response rate corrected for eligibility = 53%). Most respondents (79%) would PSA test asymptomatic men. Of these, 34% and 51% would test asymptomatic men < 50 and > 75 years, respectively. In multivariate analyses, GPs were more likely to test asymptomatic men if they were >or= 50 years, in practice >or= 10 years, female or less knowledgeable about PSA efficacy. Male GPs who would have a PSA test themselves were > 8-times more likely to PSA test asymptomatic men than GPs who would not have a test. GPs who had an asymptomatic patient diagnosed with prostate cancer following PSA testing, were > 3-times more likely to test asymptomatic men. Practice-related factors positively associated with testing included: running \\'well man\\' clinics, performing occupational health checks and performing other tests routinely with PSA. Factors positively associated with \\'inappropriate\\' testing included; being male and willing to have a PSA test, having worked\\/trained in the UK and supporting annual PSA testing. 91% of respondents supported the development of national PSA testing guidelines. CONCLUSION: Our findings suggest that widespread PSA testing

  17. The age-specific reference intervals for tPSA, fPSA, and %fPSA in healthy Han ethnic male.

    Science.gov (United States)

    Yang, Jingjing; Tang, Aiguo; Zhang, Shijie; Sun, Xiaoxu; Ming, Liang

    2017-07-01

    Prostate cancer (PC) is one of the most common malignancies in male, and has become the fastest growing malignancy in recent years. Prostate specific antigen (PSA) is widely used as a tumor marker to screen for PC. Many studies have been performed to define the reference intervals (RIs) for total circulating PSA (tPSA). The results were different among different nations and races, even in the same race. Few researches have been performed on the RIs of free PSA (fPSA) and the ratio of free to total PSA (%fPSA). In this study, we aimed to simultaneously determine the age-specific RIs for tPSA, fPSA, and %fPSA in the healthy Han ethnic male. A total of 1862 apparently healthy male aged from 21 to 94 years were included in our study. Nonparametric 95th percentile intervals were used to define the RIs. The reference limits in different age groups (21-50, 51-60, 61-70, 71-80, and ≥81 years) were 2.07, 3.59, 4.93, 6.83, and 7.73 ng/mL for tPSA, and 0.60, 0.76, 0.83, 1.30, and 2.41 ng/mL for fPSA. The RIs of %fPSA were ≥0.16 for 21-50 years and ≥0.13 for male over 50 years old. We established age-specific RIs for tPSA, fPSA and %fPSA. The newly established RIs should be more suitable for Chinese Han ethnic male. It will be valuable for physicians to make exact medical decision and appropriate medical intervention. © 2016 Wiley Periodicals, Inc.

  18. Interval cancer rates in the Irish national breast screening programme.

    Science.gov (United States)

    O'Brien, Katie M; Dwane, Fiona; Kelleher, Tracy; Sharp, Linda; Comber, Harry

    2015-09-01

    To compare interval cancer rates from the Irish breast screening programme, BreastCheck, for the period 2000-2007 with those from other European countries. Data from BreastCheck was linked to National Cancer Registry breast cancer registrations, to calculate numbers of women screened, screen-detected cancers, and interval cancers, by year of screening, in the first and second years after screening, and by initial or subsequent screen. Estimated underlying cancer incidence from the period 1996-1999 inclusive was used to calculate proportionate incidence. We calculated the interval cancer ratio as an alternative measure of the burden of interval cancers. There were 372,658 screening records for 178,147 women in the period 2000-2007. The overall interval rate was 9.6 per 10,000 screens. In the first year after screening, the interval cancer rate was 5.8 per 10,000 screens and this increased to 13.4 in the second year after screening. The screen detection rate for the period was 53.6 per 10,000 screened for all screens combined. Initial screens produced a higher detection rate at 66.9 per 10,000 screened compared with subsequent screens with a screen-detected rate of 41.4 per 10,000 screens. Interval breast cancer rates for the first years of the programme are within acceptable limits and are comparable with those in other European programmes. Nationwide roll-out together with the adoption of digital mammography may have an impact on interval cancer rates in future years. © The Author(s) 2015.

  19. Prostate Cancer Screening, Detection and Treatment Practices ...

    African Journals Online (AJOL)

    PSA) were used at similar rates for screening in all locations. Screening is primarily focused in men over age 50 and those with symptoms. Routine screening was the primary reason for screening use in SA, while symptoms were the primary ...

  20. PRESSING MORTALITY RATE THROUGH SCREENING oral cancer

    Directory of Open Access Journals (Sweden)

    L. K. Widnyani Wulan Laksmi

    2013-09-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE MicrosoftInternetExplorer4 Based on World Health Organization (WHO data, oral cancer is one of malignancy with the highest mortality. In USA, there are more than 30.000 new cases every year. We can find many risk factors of oral cancer in our daily living. Moreover, it’s easy to find the main risk factors in our society, they are smoking, alcohol consumption, tobacco consumtion, viral infection, and bad oral hygiene. For the early stadium, Five-years survival rate is about 82% and 61% for all stadium. But, more than 50% of oral cancer has been distributed (metastatic regionally and also into the other organ far away from the oral itself when it’s detected. It will decrease 5-years survival rate to be less than 50%. So that, it’s really important to detect the oral cancer at the earlier stadium. Screening is the way to find the earlier stadium. Screening is done by some methods, start from the anamnesis, physical examination, toluidine blue staining, endoscopy, cytology, telomerase examination, and also PET-scan if it’s possible (because of the financial reasons. /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  1. Rapid elimination kinetics of free PSA or human kallikrein-related peptidase 2 after initiation of gonadotropin-releasing hormone-antagonist treatment of prostate cancer

    DEFF Research Database (Denmark)

    Ulmert, David; Vickers, Andrew J; Scher, Howard I

    2012-01-01

    The utility of conventional prostate-specific antigen (PSA) measurements in blood for monitoring rapid responses to treatment for prostate cancer is limited because of its slow elimination rate. Prior studies have shown that free PSA (fPSA), intact PSA (iPSA) and human kallikrein-related peptidase...... of tPSA, fPSA, iPSA and hK2 after rapid induction of castration with degarelix (Firmagon(®)), a novel GnRH antagonist....

  2. [Total PSA, PSA density and biopsy Gleason score in predicting the pathologic stage of prostate cancer].

    Science.gov (United States)

    Liu, Shuai; Lü, Jia-ju; Fu, Qiang; Zhang, Hui; Gao, De-xuan; Liu, Zheng

    2010-05-01

    To evaluate the roles of total prostate specific antigen (tPSA), PSA density (PSAD) and biopsy Gleason score in predicting the pathologic stage of prostate cancer. We retrospectively analyzed the clinical data of 124 cases of pathologically confirmed prostate adenocarcinoma, and divided them into Groups A (n=48) and B (n=76) based on the results of bone scanning, CT, MRI, tPSA, PSAD and postoperative biopsy Gleason score, the former with extraprostatic infiltration or distant metastasis, while the latter without. We compared the above parameters between the two groups, screened the main factors that influenced the pathologic staging of prostate cancer by multivariate logistic regression analysis, and appraised the value of each of the parameters in predicting the pathologic stage of prostate cancer with a relative operating characteristic (ROC) curve. The tPSA level and biopsy Gleason score were significantly higher in Group A than in B (P Gleason score had a better predicting value than other parameters (Gleason score + tPSA > tPSA > PSAD + tPSA + Gleason score). Total PSA remains a valuable predictor of the pathologic stage of prostate cancer, and its combination with Gleason score can further improve the predictive accuracy and contribute much to the treatment and prognosis of the disease.

  3. The presence of positive surgical margins in patients with organ-confined prostate cancer results in biochemical recurrence at a similar rate to that in patients with extracapsular extension and PSA ≤ 10 ng/ml.

    Science.gov (United States)

    Eminaga, Okyaz; Hinkelammert, Reemt; Titze, Ulf; Abbas, Mahmoud; Eltze, Elke; Bettendorf, Olaf; Semjonow, Axel

    2014-01-01

    We investigated whether patients with organ-confined prostate cancer (PCa) and positive surgical margins (SMs) had a similar biochemical recurrence (BCR) risk compared with patients with pT3a and preoperative prostate-specific antigen (PSA) levels ≤ 10ng/ml. Furthermore, we examined the effects of incorporating SM status, Gleason score (Gls), and preoperative PSA level into the discrimination accuracy of the current tumor node metastasis-staging system. We analyzed 863 PCa patients treated with radical prostatectomy from 1999 to 2008. Only individuals with pT2N0 or pT3N0, without neoadjuvant or adjuvant therapy, were included. We performed chi-square automatic interaction detection analysis to generate a classification model for predicting BCR by analyzing interactions between age at surgery, SM status, Gls, PSA, and tumor stage, tumor volume and relative tumor volume. Cox regression analyses tested the relationship between SM status and BCR rate after stratification according to T-stage and the novel classification. The predictive and discrimination accuracy of the current T-stage and of the classification model was quantified with time-dependent receiver operating characteristics and integrated discrimination improvement. The topographical association between extracapsular extension of PCa and positive SM was analyzed in patients with pT3aR1 using a computational reconstruction diagram of the prostate. The chi-square automatic interaction detection analysis found interactions among pT Stage, SM status, PSA and Gls and generated a classification model for BCR prediction: pT2R0, pT2R1, pT3a PSA ≤ 10 ng/ml, pT3a PSA>10 ng/ml and pT3b. Men with pT2R1 had a shorter time to BCR compared with men with pT3a-PSA ≤ 10 ng/ml (PpT2R1/pT3a-PSA>10 ng/ml>pT2R1/pT3a PSA ≤ 10 ng/ml>pT2R0 (Pextension and positive SM was found in patients with pT3aR1 (P = 0.01). Patients with pT2R1 develop a similar BCR risk to that of patients with pT3a PSA ≤ 10 ng/ml. Gls≥7b is

  4. Intermethod differences in results for total PSA, free PSA, and percentage of free PSA.

    Science.gov (United States)

    Slev, Patricia R; La'ulu, Sonia L; Roberts, William L

    2008-06-01

    Serum prostate-specific antigen (PSA) assays differ in calibration and response to different PSA forms. We examined intermethod differences in total PSA (tPSA) and free PSA (fPSA) measurements. We tested 157 samples with tPSA concentrations of 2 to 10 ng/mL (2-10 microg/L) using 6 PSA/fPSA method pairs and 1 tPSA method: ADVIA Centaur (complexed and total; Siemens Diagnostics, Tarrytown, NY), ARCHITECT i 2000(SR) (Abbott Diagnostics, Abbott Park, IL), AxSYM (Abbott Diagnostics), IMMULITE 2000 (Siemens Diagnostics), Modular E170 (Roche Diagnostics, Indianapolis, IN), UniCel DxI 800 (Beckman Coulter, Brea, CA), and VITROS ECi (tPSA only; Ortho-Clinical Diagnostics, Raritan, NJ). Regression analysis was performed for PSA, fPSA, and percentage of fPSA with the ARCHITECT i 2000(SR) comparison method. Differences between test and comparison methods were estimated at 2.5, 4.0, and 10.0 ng/mL (2.5, 4.0, and 10.0 microg/L) for tPSA and 15%, 20%, and 25% for percentage of fPSA. Relative differences were more than 10% at 4.0 ng/mL (4.0 microg/L) tPSA for the Centaur, IMMULITE, ECi, and DxI methods. At 20% fPSA, the relative difference was more than 10% for all methods except the AxSYM. Additional harmonization is needed for tPSA and fPSA methods.

  5. Prostate cancer screening practices in a large, integrated health system: 2007-2014.

    Science.gov (United States)

    Misra-Hebert, Anita D; Hu, Bo; Klein, Eric A; Stephenson, Andrew; Taksler, Glen B; Kattan, Michael W; Rothberg, Michael B

    2017-08-01

    To assess prostate cancer screening practices in primary care since the initial United States Preventive Services Task Force (USPSTF) recommendation against prostate-specific antigen (PSA) testing for older men, and to assess primary provider variation associated with prostate cancer screening. Our study population included 160 211 men aged ≥40 years with at least one visit to a primary care clinic in any of the study years in a large, integrated health system. We conducted a retrospective cohort study using electronic medical record data from January 2007 to December 2014. Yearly rates of screening PSA testing by primary care providers (PCPs), rates of re-screening, and rates of prostate biopsies were assessed. Annual PSA-screening testing declined from 2007 to 2014 in all age groups, as did biennial and quadrennial screening. Yearly rates declined for men aged ≥70 years, from 22.8% to 8.9%; ages 50-69 years, from 39.2% to 20%; and ages 40-49 years, from 11% to 4.6%. Overall rates were lower for African-American (A-A) men vs non-A-A men; for men with a family history of prostate cancer, rates were similar or slightly higher than for those without a family history. PCP variation associated with ordering of PSA testing did not substantially change after the USPSTF recommendations. While the number of men screened and rates of follow-up prostate cancer screening declined in 2011-2014 compared to 2007-2010, similar re-screening rates were noted for men aged 45-75 years with initial PSA levels of 75 years with initial PSA levels of screened in both cohorts, follow-up screening rates were similar. Rates of prostate biopsy declined for men aged ≥70 years in 2014 compared to 2007. For men who had PSA screening, rates of first prostate biopsy increased in later years for A-A men and men with a family history of prostate cancer. Prostate cancer screening declined from 2007 to 2014 even in higher-risk groups and follow-up screening rates were not related to previous

  6. A Comparative Performance Analysis of Total PSA, Percentage Free PSA, PSA Velocity, and PSA Density versus the Detection of Primary Circulating Prostate Cells in Predicting Initial Prostate Biopsy Findings in Chilean Men

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2014-01-01

    Full Text Available Introduction. PSA parameters have been used in an attempt to improve the diagnostic yield of prostate screening tests; the detection of primary malignant circulating prostate cells (CPCs may improve the diagnostic yield of screening and therefore avoid unnecessary biopsies. Patients and Methods. Prospective study of all men undergoing initial prostate biopsy due to an elevated total serum PSA. Free percent PSA, PSA velocity, and PSA density were determined. Primary CPCs were detected using standard immunocytochemistry. A positive test for CPCs was defined as one cell PSA (+ P504S (+ in an 8 ml blood sample. Positive predictive and negative predictive values, specificity, and sensitivity were calculated for each test as well as the number of biopsies avoided and cancers missed. Results. 303 men participated in the study of whom 113/303 (37.3% men had prostate cancer. Of the three PSA based parameters, free percent PSA was superior, sensitivity 70.8%, and specificity 67.4%. Primary CPCs detection had a sensitivity of 88.5% and a specificity of 88.4% avoiding 181 (59.7% biopsies, detecting 93/95 (98% of clinically significant cancers, and missing 13 (11.5% low grade, small volume tumors. Conclusions. The use of primary CPCs as a sequential test could decrease the number of initial prostate biopsies missing those cancers which are treated by active observation.

  7. Babesiosis PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-04-25

    This 60 second PSA describes babesiosis, a preventable and treatable tickborne disease, including the signs and symptoms of infection and ways to prevent it.  Created: 4/25/2012 by Center for Global Health, Division of Parasitic Diseases and Malaria.   Date Released: 4/26/2012.

  8. Binge Drinking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-10-05

    This PSA is based on the October, 2010 CDC Vital Signs report which indicates that drinking too much, including binge drinking, causes more than 79,000 deaths in the U.S. each year and is the third leading preventable cause of death.  Created: 10/5/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/5/2010.

  9. Whooping Cough PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2015-01-22

    This 30 second PSA encourages pregnant women to get the whooping cough vaccine, called Tdap, during the third trimester of each pregnancy in order to pass antibodies to their babies so they are born with protection against this serious disease.  Created: 1/22/2015 by National Center for Immunization and Respiratory Diseases (NCIRD), Division of Bacterial Diseases (DBD), Meningitis and Vaccine Preventable Diseases Branch (MVPDB).   Date Released: 1/22/2015.

  10. A population study of fasting time and serum prostate-specific antigen (PSA) level

    OpenAIRE

    Lau, Cheryl K; Maggie Guo; Viczko, Jeannine A; Naugler, Christopher T

    2014-01-01

    Prostate cancer is one of the most common cancers in men. Traditional screening and diagnostic methods include digital rectal examinations (DREs), biopsies and serum prostate-specific antigen (PSA) tests, with the latter being the more popular. PSA is a biomarker for prostate cancer; however, it is highly sensitive to external factors as well as other prostate diseases. As such, the reliability of of the serum PSA level as a sole screening and diagnostic tool for prostate cancer is controvers...

  11. Change to FIT increased CRC screening rates: evaluation of a US screening outreach program.

    Science.gov (United States)

    Liles, Elizabeth G; Perrin, Nancy; Rosales, Ana Gabriela; Feldstein, Adrianne C; Smith, David H; Mosen, David M; Schneider, Jennifer L

    2012-10-01

    To compare completion rates of colorectal cancer screening tests within a health maintenance organization before and after widespread adoption of the fecal immunochemical test (FIT). Retrospective cohort study. Using electronic medical records of 113,901 patients eligible for colorectal cancer screening, we examined test completion during 2 successive time periods among those who received an automated screening outreach call. The time periods were: 1) the "guaiac fecal occult blood test (gFOBT) era," a 15-month period during which only gFOBT was routinely offered, and 2) a 9-month "FIT era," when only a new FIT was routinely offered. In addition to analyzing completion rates, we analyzed the impact of practice-level variables and patient-level variables on overall screening completion during the 2 different observation periods. The change from gFOBT to FIT in an integrated care delivery system increased the likelihood of screening completion by 7.7% overall, and the likelihood of screening with a fecal test by 8.9%. The greatest gains in screening completion using FIT were among women and elderly patients. Completion of FIT was not as strongly associated with medical office visits or with having a primary care provider as was screening with gFOBT. Adoption of FIT within an integrated care system increased completion of colon cancer screening tests within a 9-month assessment period, compared with a previous 15-month gFOBT era. Higher completion rates of the FIT may allow for more effective dissemination of programs to increase colorectal cancer screening through centralized outreach programs.

  12. Serum total PSA and free PSA in breast tumors

    OpenAIRE

    Dash, Prakruti; Pati, Sanghamitra; Mangaraj, Manaswini; Sahu, Pratima Kumari; Mohapatra, Prakash Chandra

    2011-01-01

    Now a days measurement of molecular forms of PSA has gained importance in clinical practice. Several studies have demonstrated the production of PSA in female tissues, such as breast. The present piece of work has been undertaken with an objective to estimate the relative proportion of the molecular forms of PSA in serum along with serum testosterone in benign and malignant breast tumor cases and to analyze their association with the severity of the disease process 34 malignant and 26 benign ...

  13. A population study of fasting time and serum prostate-specific antigen (PSA) level

    Science.gov (United States)

    Lau, Cheryl K; Guo, Maggie; Viczko, Jeannine A; Naugler, Christopher T

    2014-01-01

    Prostate cancer is one of the most common cancers in men. Traditional screening and diagnostic methods include digital rectal examinations (DREs), biopsies and serum prostate-specific antigen (PSA) tests, with the latter being the more popular. PSA is a biomarker for prostate cancer; however, it is highly sensitive to external factors as well as other prostate diseases. As such, the reliability of of the serum PSA level as a sole screening and diagnostic tool for prostate cancer is controversial. Recently, it has been shown that fasting extremes can affect concentrations of serum chemistry analytes, thus raising the question of whether or not fasting has an effect on the highly sensitive PSA biomarker. Patients testing for serum PSA levels are often concomitantly submitting to other tests that require fasting, subjecting certain patients to a fasting PSA level while others not. The objective of this study was to investigate whether this discrepancy in fasting state translates into an effect on serum PSA levels. Serum PSA levels and fasting time records for 157 276 men who underwent testing at Calgary Laboratory Services (CLS; Calgary, Alberta, Canada) between 01 January 2010 and 31 March 2013 were accessed. Linear regression models of mean PSA levels and fasting times revealed a statistically important relationship at certain fasting times. Applying a dynamic mathematical model to explore the clinical effect of fasting suggests minimal impact on serum PSA result interpretation. Thus, patients can be tested for serum PSA levels regardless of their fasting state. PMID:24994780

  14. A population study of fasting time and serum prostate-specific antigen (PSA) level.

    Science.gov (United States)

    Lau, Cheryl K; Guo, Maggie; Viczko, Jeannine A; Naugler, Christopher T

    2014-01-01

    Prostate cancer is one of the most common cancers in men. Traditional screening and diagnostic methods include digital rectal examinations (DREs), biopsies and serum prostate-specific antigen (PSA) tests, with the latter being the more popular. PSA is a biomarker for prostate cancer; however, it is highly sensitive to external factors as well as other prostate diseases. As such, the reliability of of the serum PSA level as a sole screening and diagnostic tool for prostate cancer is controversial. Recently, it has been shown that fasting extremes can affect concentrations of serum chemistry analytes, thus raising the question of whether or not fasting has an effect on the highly sensitive PSA biomarker. Patients testing for serum PSA levels are often concomitantly submitting to other tests that require fasting, subjecting certain patients to a fasting PSA level while others not. The objective of this study was to investigate whether this discrepancy in fasting state translates into an effect on serum PSA levels. Serum PSA levels and fasting time records for 157 276 men who underwent testing at Calgary Laboratory Services (CLS; Calgary, Alberta, Canada) between 01 January 2010 and 31 March 2013 were accessed. Linear regression models of mean PSA levels and fasting times revealed a statistically important relationship at certain fasting times. Applying a dynamic mathematical model to explore the clinical effect of fasting suggests minimal impact on serum PSA result interpretation. Thus, patients can be tested for serum PSA levels regardless of their fasting state.

  15. What implementation interventions increase cancer screening rates? a systematic review

    Directory of Open Access Journals (Sweden)

    Lent Barbara

    2011-09-01

    Full Text Available Abstract Background Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP change in completed screening tests. Methods Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. Results The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. Conclusion The new evidence generally aligns with the evidence and conclusions from the original systematic

  16. What implementation interventions increase cancer screening rates? a systematic review.

    Science.gov (United States)

    Brouwers, Melissa C; De Vito, Carol; Bahirathan, Lavannya; Carol, Angela; Carroll, June C; Cotterchio, Michelle; Dobbins, Maureen; Lent, Barbara; Levitt, Cheryl; Lewis, Nancy; McGregor, S Elizabeth; Paszat, Lawrence; Rand, Carol; Wathen, Nadine

    2011-09-29

    Appropriate screening may reduce the mortality and morbidity of colorectal, breast, and cervical cancers. However, effective implementation strategies are warranted if the full benefits of screening are to be realized. As part of a larger agenda to create an implementation guideline, we conducted a systematic review to evaluate interventions designed to increase the rate of breast, cervical, and colorectal cancer (CRC) screening. The interventions considered were: client reminders, client incentives, mass media, small media, group education, one-on-one education, reduction in structural barriers, reduction in out-of-pocket costs, provider assessment and feedback interventions, and provider incentives. Our primary outcome, screening completion, was calculated as the overall median post-intervention absolute percentage point (PP) change in completed screening tests. Our first step was to conduct an iterative scoping review in the research area. This yielded three relevant high-quality systematic reviews. Serving as our evidentiary foundation, we conducted a formal update. Randomized controlled trials and cluster randomized controlled trials, published between 2004 and 2010, were searched in MEDLINE, EMBASE and PSYCHinfo. The update yielded 66 studies new eligible studies with 74 comparisons. The new studies ranged considerably in quality. Client reminders, small media, and provider audit and feedback appear to be effective interventions to increase the uptake of screening for three cancers. One-on-one education and reduction of structural barriers also appears effective, but their roles with CRC and cervical screening, respectively, are less established. More study is required to assess client incentives, mass media, group education, reduction of out-of-pocket costs, and provider incentive interventions. The new evidence generally aligns with the evidence and conclusions from the original systematic reviews. This review served as the evidentiary foundation for an

  17. Co-introduction of a steroid with docetaxel chemotherapy for metastatic castration-resistant prostate cancer affects PSA flare.

    Science.gov (United States)

    Shiota, Masaki; Yokomizo, Akira; Takeuchi, Ario; Kiyoshima, Keijiro; Inokuchi, Junichi; Tatsugami, Katsunori; Shiga, Ken-Ichiro; Koga, Hirofumi; Yamaguchi, Akito; Naito, Seiji; Eto, Masatoshi

    2016-12-01

    To investigate the potential relationship of steroid usage with prostate-specific antigen (PSA) flare as well as the prognostic impact of PSA flare, which is known to occur in 10-20% of patients with metastatic castration-resistant prostate cancer during docetaxel chemotherapy. This study included 71 patients with metastatic castration-resistant prostate cancer treated by docetaxel chemotherapy with co-introduction of a steroid. PSA flare was defined as a transient PSA increase followed by a PSA decrease. PSA flare was recognized in 7.0-23.9% of patients according to the definition used. Intriguingly, men with steroid intake before the initiation of docetaxel chemotherapy experienced significantly fewer PSA flares. The progression-free survival rate in men with PSA flare was equivalent to that of PSA responders, but significantly better than men with PSA failure. Our results suggest that de novo steroid co-introduction with docetaxel chemotherapy induces the PSA flare phenomenon. This novel finding may account for the mechanism of PSA flare as well as being valuable for distinguishing PSA elevation attributable to PSA flare from that attributable to PSA failure. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  18. Degree of rate control approach to computational catalyst screening

    Energy Technology Data Exchange (ETDEWEB)

    Wolcott, Christopher A.; Medford, Andrew J.; Studt, Felix; Campbell, Charles T.

    2015-10-01

    A new method for computational catalyst screening that is based on the concept of the degree of rate control (DRC) is introduced. It starts by developing a full mechanism and microkinetic model at the conditions of interest for a reference catalyst (ideally, the best known material) and then determines the degrees of rate control of the species in the mechanism (i.e., all adsorbed intermediates and transition states). It then uses the energies of the few species with the highest DRCs for this reference catalyst as descriptors to estimate the rates on related materials and predict which are most active. The predictions of this method regarding the relative rates of twelve late transition metals for methane steam reforming, using the Rh(2 1 1) surface as the reference catalyst, are compared to the most commonly-used approach for computation catalyst screening, the Nørskov–Bligaard (NB) method which uses linear scaling relationships to estimate the energies of all adsorbed intermediates and transition states. It is slightly more accurate than the NB approach when the metals are similar to the reference metal (<0.5 eV different on a plot where the axes are the bond energies to C and O adatoms), but worse when too different from the reference. It is computationally faster than the NB method when screening a moderate number of materials (<100), thus adding a valuable complement to the NB approach. It can be implemented without a microkinetic model if the degrees of rate control are already known approximately, e.g., from experiments.

  19. Predictors of depression screening rates of nurses receiving a personal digital assistant-based reminder to screen

    National Research Council Canada - National Science Library

    Schnall, Rebecca; Currie, Leanne M; Jia, Haomiao; John, Rita Marie; Lee, Nam-Ju; Velez, Olivia; Bakken, Suzanne

    2010-01-01

    The purpose of this study was to determine if race/ethnicity, payer type, or nursing specialty affected depression screening rates in primary care settings in which nurses received a reminder to screen...

  20. Serum Prostate-Specific Antigen (PSA) Concentration, PSA Mass, and Obesity: A Mathematical Analysis.

    Science.gov (United States)

    Vollmer, Robin T

    2018-02-17

    To provide a mathematical background for understanding the phenomenon of analyte hemodilution using a kinetic analysis. The first assumption for this analysis is that change in concentration of any analyte, such as prostate-specific antigen (PSA), is due to the flux of the analyte from an organ into the blood minus its flux from the blood. What results is a relatively simple differential equation that emphasizes the importance of plasma volume, organ mass, and two rate constants. The analyses demonstrate how serum PSA can be affected by plasma volume as well as body mass and how hemodilution due to obesity can be at least partly corrected for by expressing PSA in units of total mass or total mass density. At a time when obesity is prevalent, expressing analytes in units of total mass may make them relate more closely to disease status and prognosis.

  1. Economic evaluation of prostate cancer screening test as a national cancer screening program in South Korea.

    Science.gov (United States)

    Shin, Sangjin; Kim, Youn Hee; Hwang, Jin Sub; Lee, Yoon Jae; Lee, Sang Moo; Ahn, Jeonghoon

    2014-01-01

    Prostate cancer is rapidly increasing in Korea and professional societies have requested adding prostate specific antigen (PSA) testing to the National Cancer Screening Program (NCSP), but this started a controversy in Korea and neutral evidence on this issue is required more than ever. The purpose of this study was to provide economic evidence to the decision makers of the NCSP. A cost-utility analysis was performed on the adoption of PSA screening program among men aged 50-74-years in Korea from the healthcare system perspective. Several data sources were used for the cost-utility analysis, including general health screening data, the Korea Central Cancer Registry, national insurance claims data, and cause of mortality from the National Statistical Office. To solicit the utility index of prostate cancer, a face-to-face interview for typical men aged 40 to 69 was conducted using a Time-Trade Off method. As a result, the increase of effectiveness was estimated to be very low, when adopting PSA screening, and the incremental cost effectiveness ratio (ICER) was analyzed as about 94 million KRW. Sensitivity analyses were performed on the incidence rate, screening rate, cancer stage distribution, utility index, and treatment costs but the results were consistent with the base analysis. Under Korean circumstances with a relatively low incidence rate of prostate cancer, PSA screening is not cost-effective. Therefore, we conclude that adopting national prostate cancer screening would not be beneficial until further evidence is provided in the future.

  2. Prostate-specific antigen-based population screening for prostate cancer: current status in Japan and future perspective in Asia.

    Science.gov (United States)

    Kitagawa, Yasuhide; Namiki, Mikio

    2015-01-01

    In Western countries, clinical trials on prostate cancer screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA) testing remains very low compared with Western countries, and the benefits of population-based screening remain unclear. This review describes the current status of population screening and diagnosis for prostate cancer in Japan and discusses the efficacy of population screening for the Asian population. Since the 1990s, screening systems have been administered by each municipal government in Japan, and decreases in the prostate cancer mortality rate are expected in some regions where the exposure rate to PSA screening has increased markedly. A population-based screening cohort revealed that the proportion of metastatic disease in cancer detected by screening gradually decreased according to the increased exposure rate, and a decreasing trend in the proportion of cancer with high serum PSA levels after population screening was started. The prognosis of the prostate cancer detected by population screening was demonstrated to be more favorable than those diagnosed outside of the population screening. Recent results in screening cohorts demonstrated the efficacy of PSA. These recent evidences regarding population-based screening in Japan may contribute to establishing the optimal prostate cancer screening system in Asian individuals.

  3. Prostate-specific antigen-based population screening for prostate cancer: current status in Japan and future perspective in Asia

    Directory of Open Access Journals (Sweden)

    Yasuhide Kitagawa

    2015-06-01

    Full Text Available In Western countries, clinical trials on prostate cancer screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA testing remains very low compared with Western countries, and the benefits of population-based screening remain unclear. This review describes the current status of population screening and diagnosis for prostate cancer in Japan and discusses the efficacy of population screening for the Asian population. Since the 1990s, screening systems have been administered by each municipal government in Japan, and decreases in the prostate cancer mortality rate are expected in some regions where the exposure rate to PSA screening has increased markedly. A population-based screening cohort revealed that the proportion of metastatic disease in cancer detected by screening gradually decreased according to the increased exposure rate, and a decreasing trend in the proportion of cancer with high serum PSA levels after population screening was started. The prognosis of the prostate cancer detected by population screening was demonstrated to be more favorable than those diagnosed outside of the population screening. Recent results in screening cohorts demonstrated the efficacy of PSA. These recent evidences regarding population-based screening in Japan may contribute to establishing the optimal prostate cancer screening system in Asian individuals.

  4. Serum total PSA and free PSA in breast tumors.

    Science.gov (United States)

    Dash, Prakruti; Pati, Sanghamitra; Mangaraj, Manaswini; Sahu, Pratima Kumari; Mohapatra, Prakash Chandra

    2011-04-01

    Now a days measurement of molecular forms of PSA has gained importance in clinical practice. Several studies have demonstrated the production of PSA in female tissues, such as breast. The present piece of work has been undertaken with an objective to estimate the relative proportion of the molecular forms of PSA in serum along with serum testosterone in benign and malignant breast tumor cases and to analyze their association with the severity of the disease process 34 malignant and 26 benign breast disease cases along with 33 healthy controls of same age group were enrolled in this study for evaluation. Serum testosterone was measured by ELISA, whereas serum total PSA (TPSA) and free PSA (FPSA) were estimated by electrochemiluminescence immunoassay. A significant rise of fasting plasma glucose along with prominent dyslipidemia was observed in breast tumor cases. Marked rise in serum testosterone as well as TPSA and FPSA was documented in both benign and malignant breast tumor cases. Serum testosterone revealed a significant positive association with both TPSA and FPSA pointing towards an etiological association between them. However, surgical removal of tumor mass resulted in a marked decline of presurgical value of both TPSA and FPSA with a non-significant fall in serum testosterone revealing tumor tissue as the source of FPSA and TPSA. Thus, estimation of PSA provides prognostic information that may assist in future treatment.

  5. PSA testing in Austria: induced morbidity and saved mortality.

    Science.gov (United States)

    Vutuc, Christian; Waldhoer, Thomas; Lunglmayr, Gerhard; Hoeltl, Wolfgang; Haidinger, Gerald

    2009-09-01

    Opportunistic screening of healthy men by prostate-specific antigen (PSA) testing led to a steep increase of prostate cancer incidence in Austria. The objective of this study was to quantify how many additional men are diagnosed with prostate cancer by PSA testing, to save one man from prostate cancer death. Regression models for incidence and mortality for the time periods 1983-1991 and 1992-2003 by age groups 50-59 and 60-69 years were estimated. For 1992-2003, expected numbers of incidence and mortality were calculated. The first estimates for the years 1992-2003 were calculated using the regression model including the years 1983-1991. The second estimates were also calculated using the regression model, but including only the years 1992-2003. The difference between estimates was then summed up for 1992-2003. The corresponding sums of incidence and mortality were compared to provide estimates for the effect of the introduction of PSA screening on incidence/mortality ratio. According to our calculation for the time period 1992-2003, in age group 50-69 years, a total of 512 expected prostate cancer deaths were prevented because of opportunistic PSA screening, whereas PSA testing identified a total of 9648 additional men with asymptomatic prostate cancer. In conclusion, to save one man in the age group 50-69 years in the time period 1992-2003 from prostate cancer death by PSA testing, a total of 18.8 men with asymptomatic prostate cancer had to be identified. Although this study probably underestimates the benefit (reduced mortality) and overestimates excess incidence of prostate cancer, it is far from sure that in all of these additionally identified men prostate cancer would ever have surfaced as a clinical disease, if not screened for.

  6. The effect on the sensitivities of PSA and PSA-age volume score of ...

    African Journals Online (AJOL)

    Objective: The PSA-age volume (PSA-AV) score was calculated by multiplying the age and prostate volume and then dividing the total by the prebiopsy PSA level. The aim of this study was to evaluate the effect on the sensitivities of PSA and PSA-AV score of International Prostate Symptom Score (I-PSS) and nocturia in ...

  7. Impact of PSA testing and prostatic biopsy on cancer incidence and mortality: comparative study between the Republic of Ireland and Northern Ireland.

    Science.gov (United States)

    Carsin, A-E; Drummond, F J; Black, A; van Leeuwen, P J; Sharp, L; Murray, L J; Connolly, D; Egevad, L; Boniol, M; Autier, P; Comber, H; Gavin, A

    2010-09-01

    To investigate the impact of different PSA testing policies and health-care systems on prostate cancer incidence and mortality in two countries with similar populations, the Republic of Ireland (RoI) and Northern Ireland (NI). Population-level data on PSA tests, prostate biopsies and prostate cancer cases 1993-2005 and prostate cancer deaths 1979-2006 were compiled. Annual percentage change (APC) was estimated by joinpoint regression. Prostate cancer rates were similar in both areas in 1994 but increased rapidly in RoI compared to NI. The PSA testing rate increased sharply in RoI (APC = +23.3%), and to a lesser degree in NI (APC = +9.7%) to reach 412 and 177 tests per 1,000 men in 2004, respectively. Prostatic biopsy rates rose in both countries, but were twofold higher in RoI. Cancer incidence rates rose significantly, mirroring biopsy trends, in both countries reaching 440 per 100,000 men in RoI in 2004 compared to 294 in NI. Median age at diagnosis was lower in RoI (71 years) compared to NI (73 years) (p Mortality rates declined from 1995 in both countries (APC = -1.5% in RoI, -1.3% in NI) at a time when PSA testing was not widespread. Prostatic biopsy rates, rather than PSA testing per se, were the main driver of prostate cancer incidence. Because mortality decreases started before screening became widespread in RoI, and mortality remained low in NI, PSA testing is unlikely to be the explanation for declining mortality.

  8. Effect of adding screening ultrasonography to screening mammography on patient recall and cancer detection rates: A retrospective study in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Tohno, Eriko, E-mail: tohno@tmch.or.jp [Total Health Evaluation Center Tsukuba, 1-2, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Umemoto, Takeshi, E-mail: umemoto@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Sasaki, Kyoko, E-mail: kdon@za.cyberhome.ne.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Morishima, Isamu, E-mail: morishima@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan); Ueno, Ei, E-mail: e-ueno@tmch.or.jp [Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki 305-0005 (Japan)

    2013-08-15

    Purpose: To determine whether adding screening ultrasonography to screening mammography can reduce patient recall rates and increase cancer detection rates. Materials and methods: We analyzed the results of mammography and ultrasonography breast screenings performed at the Total Health Evaluation Center Tsukuba, Japan, between April 2011 and March 2012. We also reviewed the modalities and results of diagnostic examinations from women with mammographic abnormalities who visited the Tsukuba Medical Center Hospital for further testing. Results: Of 11,753 women screened, cancer was diagnosed in 10 (0.22%) of the 4529 participants who underwent mammography alone, 23 (0.37%) of the 6250 participants who underwent ultrasonography alone, and 5 (0.51%) of the 974 participants who underwent mammography and ultrasonography. The recall rate due to mammographic abnormalities was 4.9% for women screened only with mammography and 2.6% for those screened with both modalities. The cancer detection rate was 0.22% for women screened only with mammography (positive predictive value, 4.5%) and 0.31% for those screened with both modalities (positive predictive value, 12.0%). Of the 211 lesions presenting as mammographic abnormalities investigated further, diagnostic ultrasonography found no abnormalities in 63 (29.9%) and benign findings in 69 (33.7%). The rest 36.4% needed mammography, cytological or histological examinations or follow-up in addition to diagnostic ultrasonography. Conclusions: It is possible to reduce the recall rate in screening mammography by combining mammography and ultrasonography for breast screening.

  9. [Fast test serum PSA determination (Sd Bioline PSA)].

    Science.gov (United States)

    Torrijos, Francisco Serrano de la Cruz; Alcina, Emilio López; Escudero, Joaquín Ulises Juan; Deltoro, Milagros Fabuel; García, Ana Montoliu; Romaguera, Arcadio Real; de Campos, Macarena Ramos; Vidal, Emilio Marqués

    2008-01-01

    Over the last years numerous semiquantitative PSA tests have appeared, based on serum or plasma immunochromatography. We present our experience using the SD BIOLINE PSA test, which is performed with plasma or serum for fast qualitative determination of PSA; the cutpoint is 3 ng/ml. We analized 54 patients who were admitted in our hospital ward. Two blood samples were obtained from every patient, one for cuantitative PSA determination at the hospital laboratory and the other one for qualitative determination with the SD BIOLINE PSA test, and the results were compared.. Two urologists independently interpreted the test without knowing the PSA values from the lab. To calculate the effect of test reading time, readings were performed at 15, 20 and 25 minutes. Results were classified in a classic contingency table, which enabled us to calculate sensitivity and specificity of the test, as well as positive and negative predictive values. Mean age was 71. 1 years (range 43-96 yr). From 54 patients in the study 26 (48. 14%) had a PSA > 3 ng/ml (Mean 18.5 ng/ml, range 3.9-66.9 ng/ml) and 28 (51.86%) PSA < 3 ng/ml (mean 0.8 ng/mL, range 0-2.9 ng/mL), in the conventional test. Results for each interval and observer were: 15 min: Observer 1: Sensitivity (S) 76,92%, specificity (E) 100%, positive predictive value (PPV) 100%, negative predictive value (NPV) 82.35%; Observer 2: S 76.92%, E 100%, PPV 100%, NPV 82.35%. 20 minutes: Observer 1: S 100%, E 93.33%, PPV 92.30%, NPV 100%; Observer 2: S 100%, E 93.33%, PPV 92.30%, NPV 100%. 25 minutes: Observer 1: S 100%, E 85.71%, PPV 86.66%, NPV 100%; Observer 2: S 92.30%, E 92.85%, PPV 92.30%, NPV 92.85%. The SD Bioline PSA test complies with the characteristics required to be used as a test for prostate cancer detection, it is simple, fast, cheap, not much invasive, and has a good efficacy.

  10. Registered nurses improving screening rates for non AIDS related comorbidities in people living with HIV

    National Research Council Canada - National Science Library

    Biggs, Karen; Power, Melissa

    2015-01-01

    Objective: To establish whether a nurse-led screening and brief intervention project could improve screening rates for non-AIDS comorbidities in people living with Human Immunodeficiency Virus (HIV). Design...

  11. PSA and beyond: alternative prostate cancer biomarkers

    Science.gov (United States)

    2016-01-01

    Background The use of biomarkers for prostate cancer screening, diagnosis and prognosis has the potential to improve the clinical management of the patients. Owing to inherent limitations of the biomarker prostate-specific antigen (PSA), intensive efforts are currently directed towards a search for alternative prostate cancer biomarkers, particularly those that can predict disease aggressiveness and drive better treatment decisions. Methods A literature search of Medline articles focused on recent and emerging advances in prostate cancer biomarkers was performed. The most promising biomarkers that have the potential to meet the unmet clinical needs in prostate cancer patient management and/or that are clinically implemented were selected. Conclusions With the advent of advanced genomic and proteomic technologies, we have in recent years seen an enormous spurt in prostate cancer biomarker research with several promising alternative biomarkers being discovered that show an improved sensitivity and specificity over PSA. The new generation of biomarkers can be tested via serum, urine, or tissue-based assays that have either received regulatory approval by the US Food and Drug Administration or are available as Clinical Laboratory Improvement Amendments-based laboratory developed tests. Additional emerging novel biomarkers for prostate cancer, including circulating tumor cells, microRNAs and exosomes, are still in their infancy. Together, these biomarkers provide actionable guidance for prostate cancer risk assessment, and are expected to lead to an era of personalized medicine. PMID:26790878

  12. Effects of population based screening for Chlamydia infections in the Netherlands limited by declining participation rates.

    Directory of Open Access Journals (Sweden)

    Boris V Schmid

    Full Text Available BACKGROUND: A large trial to investigate the effectiveness of population based screening for chlamydia infections was conducted in the Netherlands in 2008-2012. The trial was register based and consisted of four rounds of screening of women and men in the age groups 16-29 years in three regions in the Netherlands. Data were collected on participation rates and positivity rates per round. A modeling study was conducted to project screening effects for various screening strategies into the future. METHODS AND FINDINGS: We used a stochastic network simulation model incorporating partnership formation and dissolution, aging and a sexual life course perspective. Trends in baseline rates of chlamydia testing and treatment were used to describe the epidemiological situation before the start of the screening program. Data on participation rates was used to describe screening uptake in rural and urban areas. Simulations were used to project the effectiveness of screening on chlamydia prevalence for a time period of 10 years. In addition, we tested alternative screening strategies, such as including only women, targeting different age groups, and biennial screening. Screening reduced prevalence by about 1% in the first two screening rounds and leveled off after that. Extrapolating observed participation rates into the future indicated very low participation in the long run. Alternative strategies only marginally changed the effectiveness of screening. Higher participation rates as originally foreseen in the program would have succeeded in reducing chlamydia prevalence to very low levels in the long run. CONCLUSIONS: Decreasing participation rates over time profoundly impact the effectiveness of population based screening for chlamydia infections. Using data from several consecutive rounds of screening in a simulation model enabled us to assess the future effectiveness of screening on prevalence. If participation rates cannot be kept at a sufficient level

  13. Hepatitis Awareness Month PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2011-05-11

    May is National Hepatitis Awareness Month. This 30 second PSA discusses hepatitis and encourages listners to talk to their health care professional about getting tested.  Created: 5/11/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 5/11/2011.

  14. World AIDS Day PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2011-11-16

    December 1 is World AIDS Day. In this PSA, communities are encouraged to get tested for HIV.  Created: 11/16/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 11/16/2011.

  15. Raccoon Roundworm Infection PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-08-27

    This 60 second PSA describes the signs and symptoms of and ways to prevent Baylisascaris infection, a parasitic roundworm infection that is spread through raccoon feces.  Created: 8/27/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/28/2012.

  16. Development of a PSA information management system

    Energy Technology Data Exchange (ETDEWEB)

    Ho, Seok; Dong Kyu, Kim; Sun Koo, Kang [Korea Power Engineering Company, Inc (Korea, Republic of)

    2007-07-01

    In general, Probabilistic Safety Agreement (PSA) is a very complicated work that uses and generates a lot of resources such as reports, procedures, drawings, assumptions, calculation sheets, PSA model, and so on. In many PSAs, however, the data, materials and knowledge considered and generated during performing PSA are scattered in many documents so that overall structure of PSA and information relationship between documents and models cannot easily be understood. To organize and manage all documents related to PSA, to capture knowledge of analysts, and finally to improve the quality of PSA, a PSA information management system (PIMS) was developed. The PIMS can manage all the documents of a PSA in a database and connect the causal relation between one information to another in the scattered documents via link. The PIMS can manage all the assumptions and technical basis used in PSA, and it can keep the record of the design changes the revision of PSA model. It can also control the review results of PSA models. The link of the PIMS can explicitly describe and reveal the expertise of the PSA analysts, and it enables the users to capture the knowledge and to understand the structure and contents of a PSA with ease. We are planning to apply the PIMS to the PSA of Shin Kori Units 1 and 2 as feasibility study and then to all the PSAs of the nuclear power plants in Korea. The PIMS is expected to contribute to enhancing the quality and confidence of PSA and reducing the efforts and costs of maintenance and update of PSA. (authors)

  17. Time to Nadir PSA: Of Popes and PSA--The Immortality Bias.

    Science.gov (United States)

    Johnson, Skyler B; Jackson, William C; Murgic, Jure; Feng, Felix Y; Hamstra, Daniel A

    2015-10-01

    The objective of the study was to investigate prostate-specific antigen (PSA) nadir (nPSA) and time to nPSA (TnPSA) as prognostic variables for outcomes after definitive high-dose (>75 Gy) external beam radiation therapy (RT) without androgen deprivation therapy while correcting for immortal-time bias. nPSA and TnPSA were available for 410 patients. nPSA and TnPSA's impact on freedom from biochemical failure, freedom from metastasis, and prostate cancer-specific survival was assessed on univariate and multivariate analysis using Kaplan-Meier and Cox proportional hazards regression. Outcomes were also evaluated relative to the time since achieving nPSA and not relative to the time of RT, given the intrinsic time bias in TnPSA. Median nPSA was 0.7 ng/mL (interquartile range: 0.4 to 1.1), with a median TnPSA of 25.0 months (IQR: 15.0 to 40.0). On univariate analysis both nPSA and TnPSA were predictive of all endpoints: freedom from biochemical failure, freedom from metastasis, and prostate cancer-specific survival, as categorical (all Pimmortal-time bias the benefit of long TnPSA was mostly lost. On Cox proportional hazards, a TnPSA12 months from the time of RT the TnPSA was no longer prognostic. For dose-escalated RT a lower nPSA is prognostic, but the benefit of a long TnPSA is largely an immortal-time bias and that a longer TnPSA is not in and of itself a significant favorable factor except as compared with those with the shortest TnPSA of <12 months.

  18. The Rate of Depression Screening at a Federally Qualified Community Health Center

    Directory of Open Access Journals (Sweden)

    Richard M. Maimone BS

    2015-10-01

    Full Text Available Purpose: The purpose of this study is to examine the rate of depression screening among patients, aged 19 and older, seen at a community health center, while referencing to US Preventive Services Task Force (USPSTF screening recommendations. Methods: A random sample of 500 patients, aged 19 and older, were extracted from the total number of patients seen at the community health center, between December 1, 2013, and April 30, 2014. The rate of depression screening was calculated by analyzing the completed standardized screening questionnaires (Patient Health Questionnaire 2. Results: On analysis, it was found that 14.6% of patients were screened for depression. The rate of screening for males was 8.4% and for females it was 17.5%. The race with the highest rate of screening was Asian at 23.2%, and the lowest rate was white at 12.8%. Conclusion: The studied community health center had a suboptimal rate of depression screening at 14.6%. The USPSTF recommends depression screening on all adults. Addressing barriers to screening including patient education, provider education, system practices, and provision of resources may help improve the rate of depression screening, leading to early treatment and better health outcomes.

  19. [The Nordic cervical screening programmes through 1995. Evaluation of incidence and mortality rates, targeted age groups and screening intervals.].

    Science.gov (United States)

    Sigurdsson, K

    1999-11-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. The Nordic countries have a long experience in cervical cancer screening. Based on this experience this study evaluates the UICC and EC guidelines regarding the effectiveness of organized vs. spontaneous screening, targeted age groups and screening intervals. The study analyses the features of the Icelandic and the Nordic screening programmes and the observed trends in the incidence and mortality rates in these countries through 1995. It also analyses the trends for cytologic preinvasive lesions at first visit and at second and later visits after a normal test(s). The frequency of histologic lesions was calculated for the birth cohort 1920-1926 from the age of 60 and among women referred for colposcopic examination in 1994. Organized screening started in all the Nordic countries except Norway soon after 1960. Up to 1985 the target age group and screening interval were most intensive in Iceland. All countries intensified the screening intervals after 1985. The reduction in both the mortality and the incidence rates was greatest in Iceland and Finland, intermediate in Sweden and Denmark, and lowest in Norway but in that country organized screening started in 1994. The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno-and adenosquamous carcinomas. The prevalence of preinvasive disease has increased significantly since 1980. The rate of moderate to high-grade cytologic changes begins increasing as early as at 20 years of age and moderate to high-grade histologic lesions start to accumulate at 24 to 36 months after a normal smear. The rate of these lesions decreases with the number of negative smears taken. Moderate to high-grade histologic lesions and invasive cancer are

  20. Childhood Obesity PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-08-06

    This 60 second public service announcement is based on the August 2013 CDC Vital Signs report. The rate of obesity among low-income preschoolers has declined, but one in eight is still obese. This program briefly discusses what can be done.  Created: 8/6/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/6/2013.

  1. Colorectal Cancer - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-07-05

    This 60 second Public Service Announcement (PSA) is based on the July, 2011 CDC Vital Signs report. Colorectal cancer kills about 50,000 men and women every year. Screening can save lives! Screening can find abnormal growths so they can be removed before turning into cancer, and can find the cancer early, when it's easiest to treat. If you're over 50, talk to your doctor about getting screened for colorectal cancer.  Created: 7/5/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/5/2011.

  2. Screening for Mental Health Problems: Addressing the Base Rate Fallacy for a Sustainable Screening Program in Integrated Primary Care.

    Science.gov (United States)

    Lavigne, John V; Feldman, Marissa; Meyers, Kathryn Mendelsohn

    2016-11-01

    The Affordable Care Act has stimulated interest in screening for psychological problems in primary care. Given the scale with which screening might occur, the implications of a problem known as the base rate fallacy need to be considered. The concepts of sensitivity and specificity, positive and negative predictive value, and the base rate fallacy are discussed. The possibility that a screening program may not improve upon random selection is reviewed, as is the possibility that sequential screening might be useful. Developing effective screening programs for pediatric mental health problems is highly desirable, and properly addressing the high rate of false positives may improve the likelihood that such programs can be sustained. Consideration needs to be given to the use of sequential screening, which has both advantages and disadvantages, depending upon the type of problem to be screened for and the availability of resources for follow-up evaluations. © The Author 2016. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. The Icelandic and Nordic cervical screening programs: trends in incidence and mortality rates through 1995.

    Science.gov (United States)

    Sigurdsson, K

    1999-07-01

    The objective of cervical cancer screening is to lower the incidence and mortality rates of the disease. This study evaluates the effectiveness of cervical screening and the UICC and EC screening recommendations based on the Nordic screening experience. The study analyzes the features of the Icelandic and the Nordic screening programs and the observed trends in the incidence and mortality rates in these countries through 1995. Organized screening started in all the Nordic countries soon after 1960 and had nation-wide coverage in all these countries, except in Denmark (45% coverage in 1991), by around 1973 but in Norway screening was only spontaneous up to late in 1994. Up to 1985 the target age group and screening interval were most intensive in Iceland, followed by Finland, Sweden and Denmark. All countries except Finland lowered the lower age limit and intensified the screening intervals after 1985. Through the period 1986-1995 the reduction in both the mortality and the incidence rates was greatest in Iceland (mortality: 76% and incidence: 67%) and Finland (73% and 75%, respectively), intermediate in Sweden (60% and 55%, respectively) and Denmark (55% and 54%, respectively), and lowest in Norway (43% and 34%, respectively). The age-specific incidence in the 20-29 age group has been increasing since 1971 in all the Nordic countries, except in Finland, where the yearly registered age-specific incidence has been increasing in the targeted 30-54 age group since 1991. In Iceland screening has greatly affected the rate of all stages of squamous cell carcinoma, but not the rate of adeno- and adenosquamous carcinomas. In fact the rate of adenocarcinoma has been increasing. Organized screening is more effective than spontaneous screening in reducing the risk of cervical cancer. Although differences in environmental, biological and ethnic factors may call for different screening strategies, screening should preferably start soon after age 20 with a screening interval of 2

  4. Screening for prostate cancer using prostate-specific antigen alone as a first-line checkup parameter: results of the health checkup system.

    Science.gov (United States)

    Uchida, K; Takeshima, H; Akaza, H; Ono, Y

    2000-02-01

    The incidence of prostate cancer in Japan is not very high but it is the most increasing malignant tumor form. To decrease the mortality from cancer, detection of early cancer and early treatment are most effective. As a primary screening for prostate cancer, measurement of serum prostate-specific antigen(PSA) added to the health checkup system has not been assessed. Among males who received a health checkup during a 30-month period, serum PSA levels were measured in males who desired prostate cancer screening. The cut-off value for PSA was 4.0 ng/ml. Males with serum PSA levels exceeding this value were referred for further screening by digital rectal examination (DRE) and transrectal ultrasonography (TRUS). In secondary screening, in all males with PSA levels of 10.0 ng/ml or more and in males in whom PSA levels were within the gray zone (4.0-10.0 ng/ml) and either DRE or TRUS showed abnormal findings, systematic prostate sextant needle biopsy was performed. Of 24528 males who received a health checkup, 1125 (4.6%) underwent prostate cancer screening. In 60 (5.3%) of these males, PSA levels exceeded the cut-off value. In 34 of 50 males who received further screening, prostate biopsy was performed. Seventeen males were diagnosed as having prostate cancer. Detection rates of prostate cancer were 1.53% (17/1125) in males overall and 2.1% (17/819) in males > or =50 years old. In 16 of 17 males, clinically localized cancer was suggested. In 12 of these patients, radical prostatectomy was performed. No lymph node metastasis was detected in any patient. These results suggest that prostate cancer screening using PSA as a primary screening parameter during general health checkups is very useful for efficiently detecting early-stage prostate cancer.

  5. Impact of a Metabolic Screening Bundle on Rates of Screening for Metabolic Syndrome in a Psychiatry Resident Outpatient Clinic

    Science.gov (United States)

    Wiechers, Ilse R.; Viron, Mark; Stoklosa, Joseph; Freudenreich, Oliver; Henderson, David C.; Weiss, Anthony

    2012-01-01

    Objective: Although it is widely acknowledged that second-generation antipsychotics are associated with cardiometabolic side effects, rates of metabolic screening have remained low. The authors created a quality-improvement (QI) intervention in an academic medical center outpatient psychiatry resident clinic with the aim of improving rates of…

  6. PSA testing for men at average risk of prostate cancer

    Directory of Open Access Journals (Sweden)

    Bruce K Armstrong

    2017-07-01

    Full Text Available Prostate-specific antigen (PSA testing of men at normal risk of prostate cancer is one of the most contested issues in cancer screening. There is no formal screening program, but testing is common – arguably a practice that ran ahead of the evidence. Public and professional communication about PSA screening has been highly varied and potentially confusing for practitioners and patients alike. There has been much research and policy activity relating to PSA testing in recent years. Landmark randomised controlled trials have been reported; authorities – including the 2013 Prostate Cancer World Congress, the Prostate Cancer Foundation of Australia, Cancer Council Australia, and the National Health and Medical Research Council – have made or endorsed public statements and/or issued clinical practice guidelines; and the US Preventive Services Task Force is revising its recommendations. But disagreement continues. The contention is partly over what the new evidence means. It is also a result of different valuing and prioritisation of outcomes that are hard to compare: prostate cancer deaths prevented (a small and disputed number; prevention of metastatic disease (somewhat more common; and side-effects of treatment such as incontinence, impotence and bowel trouble (more common again. A sizeable proportion of men diagnosed through PSA testing (somewhere between 20% and 50% would never have had prostate cancer symptoms sufficient to prompt investigation; many of these men are older, with competing comorbidities. It is a complex picture. Below are four viewpoints from expert participants in the evolving debate, commissioned for this cancer screening themed issue of Public Health Research & Practice. We asked the authors to respond to the challenge of PSA testing of asymptomatic, normal-risk men. They raise important considerations: uncertainty, harms, the trustworthiness and interpretation of the evidence, cost (e.g. of using multiparametric

  7. Prostate Cancer Screening, Detection and Treatment Practices ...

    African Journals Online (AJOL)

    Routine screening was the primary reason for screening use in SA, while symptoms were the primary reason for screening use in EW. Financial and cultural barriers to screening were more commonly reported in EW than SA. Similar detection approaches were used in all regions, with free PSA and PSA velocity being more ...

  8. Geographic variation and effect of area-level poverty rate on colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Schootman Mario

    2008-10-01

    Full Text Available Abstract Background With a secular trend of increasing colorectal cancer (CRC screening, concerns about disparities in CRC screening also have been rising. It is unclear if CRC screening varies geographically, if area-level poverty rate affects CRC screening, and if individual-level characteristics mediate the area-level effects on CRC screening. Methods Using 2006 Missouri Behavioral Risk Factor Surveillance System (BRFSS data, a multilevel study was conducted to examine geographic variation and the effect of area-level poverty rate on CRC screening use among persons age 50 or older. Individuals were nested within ZIP codes (ZIP5 areas, which in turn, were nested within aggregations of ZIP codes (ZIP3 areas. Six groups of individual-level covariates were considered as potential mediators. Results An estimated 51.8% of Missourians aged 50 or older adhered to CRC screening recommendations. Nearly 15% of the total variation in CRC screening lay between ZIP5 areas. Persons residing in ZIP5 areas with ≥ 10% of poverty rate had lower odds of CRC screening use than those residing in ZIP5 areas with Conclusion Large geographic variation of CRC screening exists in Missouri. Area-level poverty rate, independent of individual-level characteristics, is a significant predictor of CRC screening, but it only explains a small portion of the geographic heterogeneity of CRC screening. Individual-level factors we examined do not mediate the effect of the area-level poverty rate on CRC screening. Future studies should identify other area- and individual-level characteristics associated with CRC screening in Missouri.

  9. Comparison of the Formula of PSA, Age, Prostate Volume and Race Versus PSA Density and the Detection of Primary Malignant Circulating Prostate Cells in Predicting a Positive Initial Prostate Biopsy in Chilean Men with Suspicion of Prostate Cancer.

    Science.gov (United States)

    Murray, Nigel P; Reyes, Eduardo; Fuentealba, Cynthia; Orellana, Nelson; Morales, Francisca; Jacob, Omar

    2015-01-01

    Combining risk factors for prostate cancer into a predictive tool may improve the detection of prostate cancer while decreasing the number of benign biopsies. We compare one such tool, age multiplied by prostate volume divided by total serum PSA (PSA-AV) with PSA density and detection of primary malignant circulating prostate cells (CPCs) in a Chilean prostate cancer screening program. The objectives were not only to determine the predictive values of each, but to determine the number of clinically significant cancers that would have been detected or missed. A prospective study was conducted of all men undergoing 12 core ultrasound guided prostate biopsy for suspicion of cancer attending the Hospital DIPRECA and Hospital de Carabineros de Chile. Total serum PSA was registered, prostate volumecalculated at the moment of biopsy, and an 8 ml blood simple taken immediately before the biopsy procedure. Mononuclear cells were obtained from the blood simple using differential gel centrifugation and CPCs identified using immunocytchemistry with anti- PSA and anti-P504S. Biopsy results were classed as positive or negative for cancer and if positive the Gleason score, number of positive cores and percent infiltration recorded. A total of 664 men participated, of whom 234 (35.2%) had cancer detected. They were older, had higher mean PSA, PSA density and lower PSA-AV. Detection of CPCs had high predictive score, sensitivity, sensibility and positive and negative predictive values, PSA-AV was not significantly different from PSA density in this population. The use of CPC detection avoided more biopsies and missed fewer significant cancers. In this screening population the use of CPC detection predicted the presence of clinically significant prostate cancer better than the other parameters. The high negative predictive value would allow men CPC negative to avoid biopsy but remain in follow up. The formula PSA-AV did not add to the predictive performance using PSA density.

  10. Testing the variability of PSA expression by different human prostate cancer cell lines by means of a new potentiometric device employing molecularly antibody assembled on graphene surface

    Energy Technology Data Exchange (ETDEWEB)

    Rebelo, Tânia S.C.R. [BioMark-CINTESIS/ISEP, Instituto Superior de Engenharia do Instituto Politécnico do Porto (Portugal); LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica (Portugal); Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); Noronha, João P.; Galésio, Marco; Santos, Hugo; Diniz, Mário [LAQV, REQUIMTE, Departamento de Química, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica (Portugal); Sales, M. Goreti F. [BioMark-CINTESIS/ISEP, Instituto Superior de Engenharia do Instituto Politécnico do Porto (Portugal); Fernandes, Maria H. [Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); Costa-Rodrigues, João, E-mail: jrodrigues@fmd.up.pt [Laboratory for Bone Metabolism and Regeneration, Faculdade de Medicina Dentária, Universidade do Porto, Porto (Portugal); ESTSP — Escola Superior de Tecnologia da Saúde do Porto, Instituto Politécnico do Porto (Portugal)

    2016-02-01

    Prostate Specific Antigen (PSA) is widely used as a biomarker for prostate cancer. Recently, an electrochemical biosensor for PSA detection by means of molecularly imprinted polymers (MIPs) was developed. This work evaluated the performance and the effectiveness of that PSA biosensor in screening the biomarker PSA in biological media with complex composition, collected from different human prostate cell line cultures. For that, the prostate cancer LNCaP and PC3 cells, and the non-cancerous prostate cell line PNT2 were cultured for 2, 7 and 14 days in either α-MEM or RPMI in the presence of 10% or 30% fetal bovine serum. Human gingival fibroblasts were used as a non-cancerous non-prostatic control. The different culture conditions modulated cellular proliferation and the expression of several prostate markers, including PSA. The electrochemical biosensor was able to specifically detect PSA in the culture media and values obtained were similar to those achieved by a commercial Enzyme-Linked Immunosorbent Assay (ELISA) kit, the most commonly used method for PSA quantification in prostate cancer diagnosis. Thus, the tested biosensor may represent a useful alternative as a diagnostic tool for PSA determination in biological samples. - Highlights: • PSA quantification was performed in prostate cancer cell culture media. • Culture media composition and culture period significantly affect PSA production. • The PSA biosensor detected a wide range of PSA levels in complex media. • A high data correlation was observed between the biosensor and the ELISA analysis.

  11. Hepatitis A and B screening and vaccination rates among patients with chronic liver disease.

    Science.gov (United States)

    Ramirez, Jonathan C; Ackerman, Kimberly; Strain, Sasha C; Ahmed, Syed T; de Los Santos, Mario J; Sears, Dawn

    2016-01-01

    Vaccinations against hepatitis A virus (HAV) and hepatitis B virus (HBV) are recommended for patients with chronic liver disease (CLD), yet implementation of these recommendations is lacking. This study reviewed HAV and HBV antibody testing and vaccination status of patients with CLD. In 2008, we began using pre-printed liver order sets, which included vaccination options. We compared Scott & White liver clinic CLD patient records from 2005 (238) with patient records from 2008 (792). Screening rates for immunity and vaccination rates of those lacking immunity were calculated. In 2005, 66% of CLD patients were screened for HAV immunity. In 2008, 56% of CLD patients were screened. The HAV vaccination completion rate was 37% in 2005, while in 2008, the rate was 46%. In 2005, 66% of CLD patients were screened for HBV immunity; in 2008, 56 % CLD patients were screened. The HBV vaccination completion rate was 26% in 2005 compared with 36% in 2008. Although there was a lower percentage of screening in 2008, the overall number of patients tripled between 2005 and 2008. There was a significant increase in the total number of patients screened and vaccinated in 2008. Some physicians may have vaccinated their patients without checking for immunity. In January 2008, we implemented pre-printed order sets with checkboxes to help remind providers to order labs to screen for immunity against HAV and HBV and to order vaccinations for those who lacked immunity. The use of these sets may have aided in the increase of vaccination completion rates.

  12. Detection rate of prostate cancer using prostate specific antigen in patients presenting with lower urinary tract symptoms: A retrospective study

    Directory of Open Access Journals (Sweden)

    Chavan P

    2009-01-01

    Full Text Available Background: Need for undertaking prostate biopsies for detection of prostate cancer is often decided on the basis of serum levels of prostate specific antigen (PSA. Aim: To evaluate the case detection rate of prostate cancer among patients presenting with lower urinary tract symptoms (LUTS on the basis of PSA levels and to assess the scope of prostate biopsy in these patients. Setting and Design: A retrospective study from a tertiary care center. Materials and Methods: The clinical and histopathological data of 922 patients presenting with LUTS in the last five years was obtained from the medical record section. They had been screened for prostate cancer using PSA and /or digital rectal examination examination followed by confirmation with prostate biopsy. Statistical Analysis Used: Detection rate and receiver operating characteristic curve were performed using SPSS 16 and Medcalc softwares. Results: The detection rate of prostate cancer according to the PSA levels was 0.6%, 2.3%, 2.5%, 34.1% and 54.9% in the PSA range of 0-4, 4-10, 10-20, 20-50 and> 50 ng/ml, respectively. Maximum prostate cancer cases were detected beyond a PSA value of 20 ng/ml whereas no significant difference in the detection rate was observed in the PSA range of 0-4, 4-10 and 10-20 ng/ml. Conclusion: A low detection rate of prostate cancer observed in the PSA range of 4-20 ng/ml in LUTS patients indicates the need for use of higher cutoff values of PSA in such cases. Therefore we recommend a cutoff of 20 ng/ml of PSA for evaluation of detection rate of prostate cancer among patients presenting with LUTS.

  13. Too Much Sodium PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-02-07

    This 60 second PSA is based on the February 2012 CDC Vital Signs report. Ninety percent of Americans age two and older eat too much sodium which can increase your risk for high blood pressure and often leads to heart disease and stroke, two leading causes of death in the US. Learn several small steps you can take to reduce the amount of sodium in your diet.  Created: 2/7/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 2/7/2012.

  14. Prostate-specific antigen-based population screening for prostate cancer: current status in Japan and future perspective in Asia

    OpenAIRE

    Yasuhide Kitagawa; Mikio Namiki

    2014-01-01

    In Western countries, clinical trials on prostate cancer screening demonstrated a limited benefit for patient survival. In the Asia-Pacific region, including Japan, the rate of prostate-specific antigen (PSA) testing remains very low compared with Western countries, and the benefits of population-based screening remain unclear. This review describes the current status of population screening and diagnosis for prostate cancer in Japan and discusses the efficacy of population screening for the ...

  15. Accessibility and screening uptake rates for gestational diabetes mellitus in Ireland.

    LENUS (Irish Health Repository)

    Cullinan, John

    2012-03-01

    Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance with onset or first recognition during pregnancy and is associated with a range of maternal and neonatal complications and conditions. Given increasing levels of prevalence worldwide, there are growing calls for the implementation of screening practices to identify and treat positive GDM cases. This paper uses a unique dataset to investigate the role of healthcare centre accessibility on the decision to attend for screening, employing geographic information systems, econometric and simulation techniques. We focus on the extent to which \\'travel distance to screening hospital site\\' impacts upon the individual\\'s screen uptake decision, whether significant geographic inequalities exist in relation to accessibility to screening, and the likely impact on uptake rates of providing screening services at a local level via primary care. Our findings have important implications for the provision of GDM screening services.

  16. PSA bounce after {sup 125}I-brachytherapy for prostate cancer as a favorable prognosticator

    Energy Technology Data Exchange (ETDEWEB)

    Engeler, Daniel S.; Schwab, Christoph; Schmid, Hans-Peter [Cantonal Hospital St. Gallen, Department of Urology, St. Gallen (Switzerland); Thoeni, Armin F. [Lindenhofspital Berne, Department of Radiation Oncology, Berne (Switzerland); Hochreiter, Werner [Hirslanden Klinik Aarau, Department of Urology, Aarau (Switzerland); Prikler, Ladislav [Klinik Uroviva Buelach, Department of Urology, Buelach (Switzerland); Suter, Stefan [Cantonal Hospital Zug, Department of Urology, Zug (Switzerland); Stucki, Patrick [Cantonal Hospital Lucerne, Department of Urology, Lucerne (Switzerland); Schiefer, Johann; Plasswilm, Ludwig; Putora, Paul Martin [Cantonal Hospital St. Gallen, Department of Radiation Oncology, St. Gallen (Switzerland)

    2015-10-15

    Permanent low-dose-rate brachytherapy (BT) with iodine 125 is an established curative treatment for localized prostate cancer. After treatment, prostate-specific antigen (PSA) kinetics may show a transient rise (PSA bounce). Our aim was to investigate the association of PSA bounce with biochemical control. Patients treated with BT in Switzerland were registered in a prospective database. Only patients with a follow-up of at least 2 years were included in our analysis. Clinical follow-up and PSA measurements were assessed after 1.5, 3, 6, and 12 months, and annually thereafter. If PSA increased, additional follow-up visits were scheduled. Cases of PSA bounce were defined as a rise of at least 0.2 ng/ml above the initial PSA nadir with a subsequent decline to or below the initial nadir without treatment. Biochemical failure was defined as a rise to nadir + 2 ng/ml. Between March 2001 and November 2010, 713 patients with prostate cancer undergoing BT with at least 2 years of follow-up were registered. Median follow-up time was 41 months. Biochemical failure occurred in 28 patients (3.9 %). PSA bounce occurred in 173 (24.3 %) patients; only three (1.7 %) patients with PSA bounce developed biochemical failure, in contrast to 25 (4.6 %) patients without previous bounce (p < 0.05). The median time to bounce was 12 months, the median time to biochemical failure was 30 months. The median bounce increase was 0.78 ng/ml. Twenty-eight patients with bounce (16.5 %) had a transient PSA rise of + 2 ng/ml above the nadir. In most cases, an early increase in PSA after BT indicates PSA bounce and is associated with a lower risk of biochemical failure. (orig.) [German] Die permanente Low-dose-rate-Brachytherapie (BT) mit {sup 125}I ist ein etabliertes kuratives Verfahren bei lokalisiertem Prostatakarzinom. Posttherapeutisch koennen die PSA-Konzentrationen einen voruebergehenden Anstieg zeigen (Bounce-Phaenomen). Untersucht werden sollte ein moeglicher Zusammenhang mit der

  17. Disparities in colorectal cancer screening rates among Asian Americans and non-Latino whites.

    Science.gov (United States)

    Wong, Sabrina T; Gildengorin, Ginny; Nguyen, Tung; Mock, Jeremiah

    2005-12-15

    Among Asian Americans, colorectal cancer (CRC) is the second most commonly diagnosed cancer, and it is the third highest cause of cancer-related mortality. The 2001 California Health Interview Survey (CHIS 2001) was used to examine 1) CRC screening rates between different Asian-American ethnic groups compared with non-Latino whites and 2) factors related to CRC screening. The CHIS 2001 was a population-based telephone survey that was conducted in California. Responses about CRC screening were analyzed from 1771 Asian Americans age 50 years and older (Chinese, Filipino, South Asian, Japanese, Korean, and Vietnamese). The authors examined two CRC screening outcomes: individuals who ever had CRC screening and individuals who were up to date for CRC screening. For CRC screening, fecal occult blood test (FOBT), sigmoidoscopy/colonoscopy, and any other form of screening were examined. CRC screening of any kind was low in all populations, and Koreans had the lowest rate (49%). Multivariate analysis revealed that, compared with non-Latino whites, Koreans were less likely to undergo FOBT (odds ratio [OR], 0.40; 95% confidence interval [95% CI], 0.25-0.62), and Filipinos were the least likely to undergo sigmoidoscopy/colonoscopy (OR, 0.62; 95% CI, 0.44-0.88) or to be up to date with screening (OR, 0.68; 95% CI, 0.48-0.97). Asian Americans were less likely to undergo screening if they were older, male, less educated, recent immigrants, living with >or= 3 individuals, poor, or uninsured. Asian-American populations, especially Koreans and Filipinos, are under-screened for CRC. Outreach efforts could be more focused on helping Asian Americans to understand the importance of CRC screening, providing accurate information in different Asian languages. Other strategies for increasing CRC screening may include using a more family-centered approach and using qualified translators. Cancer 2005. (c) 2005 American Cancer Society.

  18. 40 CFR Appendix II to Part 266 - Tier I Feed Rate Screening Limits for Total Chlorine

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier I Feed Rate Screening Limits for Total Chlorine II Appendix II to Part 266 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Screening Limits for Total Chlorine Terrain-adjusted effective stack height (m) Noncomplex Terrain Urban (g...

  19. Independent screening for single-index hazard rate models with ultrahigh dimensional features

    DEFF Research Database (Denmark)

    Gorst-Rasmussen, Anders; Scheike, Thomas

    2013-01-01

    can be viewed as the natural survival equivalent of correlation screening. We state conditions under which the method admits the sure screening property within a class of single-index hazard rate models with ultrahigh dimensional features and describe the generally detrimental effect of censoring...

  20. Decreased rates of advanced breast cancer due to mammography screening in The Netherlands

    NARCIS (Netherlands)

    J. Fracheboud (Jacques); S.J. Otto (Suzie); J.A.A.M. van Dijck; M.J.M. Broeders (Mireille); A.L.M. Verbeek (Andre); H.J. de Koning (Harry)

    2004-01-01

    textabstractThe effect of the implementation of the Dutch breast cancer screening programme during 1990-1997 on the incidence rates of breast cancer, particularly advanced breast cancer, was analysed according to stage at diagnosis in seven regions, where no screening took place before 1990. The

  1. Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

    Science.gov (United States)

    Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

    2017-11-01

    To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (PEarly diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

  2. Improving breast and colon cancer screening rates: a comparison of letters, automated phone calls, or both.

    Science.gov (United States)

    Phillips, Lindsay; Hendren, Samantha; Humiston, Sharon; Winters, Paul; Fiscella, Kevin

    2015-01-01

    Low-cost interventions to improve cancer screening among primary care patients are needed. The comparative effectiveness of personalized letters, automated telephone calls, and both on breast cancer (BC) and colorectal cancer (CRC) screening is not known. A pragmatic, randomized, controlled trial was conducted in 2011 to 2012. Eligible primary care patients were women ages 50 to 74 years who were past due for mammography and men or women who were past due for mammography or CRC screening of any kind (>12 months since last fecal occult blood test, >5 years since last sigmoidoscopy/double-contrast barium enema, or >10 years since last colonoscopy), respectively. Participants were randomized to 1 of 3 interventions: personalized mailed letters, automated telephone calls, or both. The primary outcome was medical record documentation of a completed mammogram or CRC screening within 36 weeks of randomization. We estimated the costs of each intervention and calculated the marginal cost-effectiveness per person screened. The crude screening rates for BC were 19%, 22%, and 37% and for CRC were 17%, 14%, and 24% for the letter, automated call, and combined (letter/automated call) groups, respectively. The combined intervention group had a statistically higher screening rate (P costs $5.11 per additional person screened for BC and $13.14 per additional person screened for CRC. In a primary care practice, letters plus automated telephone calls are better than either alone in increasing cancer screening rates among patients who are overdue for screening. These findings suggest the promise of a relatively inexpensive intervention to improve cancer screening. © Copyright 2015 by the American Board of Family Medicine.

  3. Impact of vital signs screening & clinician prompting on alcohol and tobacco screening and intervention rates: a pre-post intervention comparison

    Directory of Open Access Journals (Sweden)

    Vinson Dan

    2010-03-01

    Full Text Available Abstract Background Though screening and intervention for alcohol and tobacco misuse are effective, primary care screening and intervention rates remain low. Previous studies have increased intervention rates using vital signs screening for tobacco misuse and clinician prompts for screen-positive patients for both alcohol and tobacco misuse. This pilot study's aims were: (1 To determine the feasibility of combined vital signs screening for tobacco and alcohol misuse, (2 To assess the impact of vital signs screening on alcohol and tobacco screening and intervention rates, and (3 To assess the additional impact of tobacco assessment prompts on intervention rates. Methods In five outpatient practices, nurses measuring vital signs were trained to routinely ask a single tobacco question, a prescreening question that identified current drinkers, and the single alcohol screening question for current drinkers. After 4-8 weeks, clinicians were trained in tobacco intervention and nurses were trained to give tobacco abusers a tobacco questionnaire which also served as a clinician intervention prompt. Screening and intervention rates were measured using patient exit interviews (n = 622 at baseline, during the "screening only" period, and during the tobacco prompting phase. Changes in screening and intervention rates were compared using chi square analyses and test of linear trends. Clinic staff were interviewed regarding patient and staff acceptability. Logistic regression was used to evaluate the impact of nurse screening on clinician intervention, the impact of alcohol intervention on concurrent tobacco intervention, and the impact of tobacco intervention on concurrent alcohol intervention. Results Alcohol and tobacco screening rates and alcohol intervention rates increased after implementing vital signs screening (p Conclusions Vital signs screening can be incorporated in primary care and increases alcohol screening and intervention rates. Tobacco

  4. The Effect of Screening Factors and Thermonuclear Reaction Rates ...

    Indian Academy of Sciences (India)

    In understanding the nucleosynthesis of the elements in stars, one of the most important quantities is the reaction rate and it must be evaluated in terms of the stellar temperature , and its determination involves the knowledge of the excitation function () of the specific nuclear reaction leading to the final nucleus. In this ...

  5. Prostate-specific antigen (PSA) blood test

    Science.gov (United States)

    ... look at your PSA result and consider your age, ethnicity, medicines you are taking, and other things to ... things when deciding on the next step: Your age If you had a PSA test ... such as ethnicity and family history Men at high risk may ...

  6. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Jonah Musa

    Full Text Available Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally.The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS rates compared to control conditions in eligible women population at risk of cervical cancer.We used the PICO (Problem or Population, Interventions, Comparison and Outcome framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO. The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA. We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot.Out of 3072 study reports screened, 28 articles were found to

  7. Effect of cervical cancer education and provider recommendation for screening on screening rates: A systematic review and meta-analysis

    Science.gov (United States)

    Achenbach, Chad J.; O’Dwyer, Linda C.; Evans, Charlesnika T.; McHugh, Megan; Hou, Lifang; Simon, Melissa A.; Murphy, Robert L.; Jordan, Neil

    2017-01-01

    Background Although cervical cancer is largely preventable through screening, detection and treatment of precancerous abnormalities, it remains one of the top causes of cancer-related morbidity and mortality globally. Objectives The objective of this systematic review is to understand the evidence of the effect of cervical cancer education compared to control conditions on cervical cancer screening rates in eligible women population at risk of cervical cancer. We also sought to understand the effect of provider recommendations for screening to eligible women on cervical cancer screening (CCS) rates compared to control conditions in eligible women population at risk of cervical cancer. Methods We used the PICO (Problem or Population, Interventions, Comparison and Outcome) framework as described in the Cochrane Collaboration Handbook to develop our search strategy. The details of our search strategy has been described in our systematic review protocol published in the International Prospective Register of systematic reviews (PROSPERO). The protocol registration number is CRD42016045605 available at: http://www.crd.york.ac.uk/prospero/display_record.asp?src=trip&ID=CRD42016045605. The search string was used in Pubmed, Embase, Cochrane Systematic Reviews and Cochrane CENTRAL register of controlled trials to retrieve study reports that were screened for inclusion in this review. Our data synthesis and reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). We did a qualitative synthesis of evidence and, where appropriate, individual study effects were pooled in meta-analyses using RevMan 5.3 Review Manager. The Higgins I2 was used to assess for heterogeneity in studies pooled together for overall summary effects. We did assessment of risk of bias of individual studies included and assessed risk of publication bias across studies pooled together in meta-analysis by Funnel plot. Results Out of 3072 study reports screened

  8. No reason for immediate repeat sextant biopsy after negative initial sextant biopsy in men with PSA level of 4.0 ng/mL or greater (ERSPC, Rotterdam).

    Science.gov (United States)

    Roobol, M J; van der Cruijsen, I W; Schröder, F H

    2004-05-01

    In the early detection of prostate cancer (CaP) uncertainty exists concerning the most appropriate biopsy procedure. Within the European Randomized Study of Screening for Prostate Cancer (ERSPC) lateralized sextant biopsies are used. False-negative results of sextant biopsies have led to the extensive use of procedures using 12 or more biopsy cores. The ERSPC offers the opportunity to study the yield of repeat biopsies after 4 years in men who had negative sextant biopsies and a prostate-specific antigen (PSA) level of 4.0 mg/mL or more at the first screening round. Between August 1996 and May 1998, a total of 6876 men (age 55 to 74 years) were randomized to the screening arm and actually underwent screening. The numbers and levels of biopsy indicators, as well as possible predictors for biopsy outcome, in the second screening round, such as prostate volume, volume change over time, prostate-specific antigen density (PSAD), PSA velocity, and age, were calculated and compared for participants with positive and negative biopsies in round 2. The positive predictive value (PPV) and detection rates, as well as parameters of aggressiveness, were evaluated for second-round biopsy-detected and interval CaP cases. Of the 728 men with a PSA level of 4.0 mg/mL or more who underwent biopsy at initial screening, 553 were eligible for a second screening visit after 4 years. Of these, 272 (49.2%) actually underwent screening. Eighteen CaP cases were detected with 217 biopsies, indicated by a PSA level of 3.0 ng/mL or more (PPV 8.3%). Eight interval cases were identified by linking to the Cancer Registry. These 26 cases would have increased the PPV and detection rate of the initial screening round from 36.1% to 39.7% and from 3.8% to 4.2%, respectively. Most of these cases (23 of 26 or 88.5%) were organ confined and amenable to potentially curative treatment. Although the results of this study may have been biased by the low rate of availability/eligibility of participants for

  9. Decision criteria in PSA applications

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, J.E.; Pulkkinen, U.; Rosqvist, T.; Simola, K. [VTT Automation (Finland)

    2001-11-01

    Along with the adoption of risk informed decision making principles, the need for formal probabilistic decision rule or criteria has been risen. However, there are many practical and theoretical problems in the application of probabilistic criteria. One has to think what is the proper way to apply probabilistic rules together with deterministic ones and how the criteria are weighted with respect to each other. In this report, we approach the above questions from the decision theoretic point of view. We give a short review of the most well known probabilistic criteria, and discuss examples of their use. We present a decision analytic framework for evaluating the criteria, and we analyse how the different criteria behave under incompleteness or uncertainty of the PSA model. As the conclusion of our analysis we give recommendations on the application of the criteria in different decision situations. (au)

  10. Cost Effectiveness of Screening Colonoscopy Depends on Adequate Bowel Preparation Rates - A Modeling Study.

    Directory of Open Access Journals (Sweden)

    James Kingsley

    Full Text Available Inadequate bowel preparation during screening colonoscopy necessitates repeating colonoscopy. Studies suggest inadequate bowel preparation rates of 20-60%. This increases the cost of colonoscopy for our society.The aim of this study is to determine the impact of inadequate bowel preparation rate on the cost effectiveness of colonoscopy compared to other screening strategies for colorectal cancer (CRC.A microsimulation model of CRC screening strategies for the general population at average risk for CRC. The strategies include fecal immunochemistry test (FIT every year, colonoscopy every ten years, sigmoidoscopy every five years, or stool DNA test every 3 years. The screening could be performed at private practice offices, outpatient hospitals, and ambulatory surgical centers.At the current assumed inadequate bowel preparation rate of 25%, the cost of colonoscopy as a screening strategy is above society's willingness to pay (<$50,000/QALY. Threshold analysis demonstrated that an inadequate bowel preparation rate of 13% or less is necessary before colonoscopy is considered more cost effective than FIT. At inadequate bowel preparation rates of 25%, colonoscopy is still more cost effective compared to sigmoidoscopy and stool DNA test. Sensitivity analysis of all inputs adjusted by ±10% showed incremental cost effectiveness ratio values were influenced most by the specificity, adherence, and sensitivity of FIT and colonoscopy.Screening colonoscopy is not a cost effective strategy when compared with fecal immunochemical test, as long as the inadequate bowel preparation rate is greater than 13%.

  11. Simulation of internal contamination screening with dose rate meters

    Science.gov (United States)

    Fonseca, T. C. F.; Mendes, B. M.; Hunt, J. G.

    2017-11-01

    Assessing the intake of radionuclides after an accident in a nuclear power plant or after the intentional release of radionuclides in public places allows dose calculations and triage actions to be carried out for members of the public and for emergency response teams. Gamma emitters in the lung, thyroid or the whole body may be detected and quantified by making dose rate measurements at the surface of the internally contaminated person. In an accident scenario, quick measurements made with readily available portable equipment are a key factor for success. In this paper, the Monte Carlo program Visual Monte Carlo (VMC) and MCNPx code are used in conjunction with voxel phantoms to calculate the dose rate at the surface of a contaminated person due to internally deposited radionuclides. A whole body contamination with 137Cs and a thyroid contamination with 131I were simulated and the calibration factors in kBq per μSv/h were calculated. The calculated calibration factors were compared with real data obtained from the Goiania accident in the case of 137Cs and the Chernobyl accident in terms of the 131I. The close comparison of the calculated and real measurements indicates that the method may be applied to other radionuclides. Minimum detectable activities are discussed.

  12. Prostate Cancer Screening

    Science.gov (United States)

    ... treat. There is no standard screening test for prostate cancer. Researchers are studying different tests to find those ... PSA level may be high if you have prostate cancer. It can also be high if you have ...

  13. Detection Rates for Aneuploidy by First-Trimester and Sequential Screening.

    Science.gov (United States)

    Baer, Rebecca J; Flessel, Monica C; Jelliffe-Pawlowski, Laura L; Goldman, Sara; Hudgins, Louanne; Hull, Andrew D; Norton, Mary E; Currier, Robert J

    2015-10-01

    To estimate detection rates for aneuploidy by first-trimester and sequential screening. The study included women with singleton pregnancies who participated in the California Prenatal Screening Program with estimated delivery dates from August 2009 to December 2012 who had first- or first- and second-trimester (sequential) screening. Detection rates were measured for target (trisomies 21 and 18) and other aneuploidies identified from the California Chromosome Defect Registry. Of 452,901 women screened, 17,435 (3.8%) were screen-positive for Down syndrome only; 433 (0.1%) for trisomy 18 only; 1,689 (0.4%) for both Down syndrome and trisomy 18; and 2,947 (0.7%) for neural tube defects, Smith-Lemli-Opitz syndrome, or for multiple conditions. The detection rates were Down syndrome-92.9% (95% confidence interval [CI] 91.4-94.2); trisomy 18-93.2% (95% CI 90.5-95.9); trisomy 13-80.4% (95% CI 73.9-86.9); 45,X-80.1% (95% CI 73.9-86.3), and triploidy-91.0% (95% CI 84.2-97.9). Overall, the detection rate for chromosome abnormalities was 81.6% (95% CI 80.0-83.1) at an overall false-positive rate of 4.5%. First-trimester and sequential screening are sensitive and specific for the broad range of karyotype abnormalities seen in the population. II.

  14. Low hospital referral rates of school scoliosis screening positives in an urban district of mainland China.

    Science.gov (United States)

    Guo, Yawen; Jiang, Qingwu; Tanimoto, Tetsuya; Kami, Masahiro; Luo, Chunyan; Leppold, Claire; Nishimura, Koichi; He, Yongpin; Kato, Shigeaki; Ding, Xiaocang

    2017-04-01

    Significant prevalence rates of adolescent scoliosis in China were suggested in previous studies. However, school screenings for adolescent scoliosis have been suspended due to low rates of positive detection under the past screening system in China. The present study was undertaken to screen for adolescent scoliosis in middle school students under a modern assessment system in a district of Shanghai. We performed a population-based, cross-sectional study of a middle school scoliosis screening program in the Jingan district. In 2015, schoolchildren were initially screened by visual inspection of clinical signs and the forward-bending test. Suspected cases were referred for radiography in hospital for scoliosis diagnosis. A total of 5327 middle school students (grades 6-8) were screened with 520 (9.76%) positives (the positive rates of girls and boys at 15.28% and 4.59%, respectively) and no statistically significant difference among grades. Only 301 positives (57.9%) followed the referral for hospital radiography. There were 102 cases (33.9%) that were diagnosed with scoliosis by radiography criteria (Cobb angle ≥10°) including mild scoliosis (Cobb 10-25) for 94 cases and moderate scoliosis (Cobb 25-40) for 8 cases, and false-positives (Cobb 0) for 39 cases. The putative prevalence rate was estimated as 1.9% from the referred students. Under an accurate and modern assessment system, school screenings can detect scoliosis at a significant rate, but awareness of scoliosis risks is needed for residents in China to take up referrals for hospital diagnosis after school screenings.

  15. Utilization of cervical cancer screening services and trends in screening positivity rates in a 'screen-and-treat' program integrated with HIV/AIDS care in Zambia.

    Directory of Open Access Journals (Sweden)

    Mulindi H Mwanahamuntu

    Full Text Available In the absence of stand-alone infrastructures for delivering cervical cancer screening services, efforts are underway in sub-Saharan Africa to dovetail screening with ongoing vertical health initiatives like HIV/AIDS care programs. Yet, evidence demonstrating the utilization of cervical cancer prevention services in such integrated programs by women of the general population is lacking.We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia (CCPPZ, the largest public sector programs of its kind in sub-Saharan Africa. We evaluated patterns of utilization of screening services by HIV serostatus, examined contemporaneous trends in screening outcomes, and used multivariable modeling to identify factors associated with screening test positivity.Between January 2006 and April 2011, CCPPZ services were utilized by 56,247 women who underwent cervical cancer screening with visual inspection with acetic acid (VIA, aided by digital cervicography. The proportion of women accessing these services who were HIV-seropositive declined from 54% to 23% between 2006-2010, which coincided with increasing proportions of HIV-seronegative women (from 22% to 38% and women whose HIV serostatus was unknown (from 24% to 39% (all p-for trend<0.001. The rates of VIA screening positivity declined from 47% to 17% during the same period (p-for trend <0.001, and this decline was consistent across all HIV serostatus categories. After adjusting for demographic and sexual/reproductive factors, HIV-seropositive women were more than twice as likely (Odds ratio 2.62, 95% CI 2.49, 2.76 to screen VIA-positive than HIV-seronegative women.This is the first 'real world' demonstration in a public sector implementation program in a sub-Saharan African setting that with successful program scale-up efforts, nurse-led cervical cancer screening programs targeting women with HIV can expand and serve all women, regardless of HIV serostatus. Screening program

  16. Utilization of cervical cancer screening services and trends in screening positivity rates in a 'screen-and-treat' program integrated with HIV/AIDS care in Zambia.

    Science.gov (United States)

    Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Blevins, Meridith; Kapambwe, Sharon; Shepherd, Bryan E; Chibwesha, Carla; Pfaendler, Krista S; Mkumba, Gracilia; Vwalika, Belington; Hicks, Michael L; Vermund, Sten H; Stringer, Jeffrey Sa; Parham, Groesbeck P

    2013-01-01

    In the absence of stand-alone infrastructures for delivering cervical cancer screening services, efforts are underway in sub-Saharan Africa to dovetail screening with ongoing vertical health initiatives like HIV/AIDS care programs. Yet, evidence demonstrating the utilization of cervical cancer prevention services in such integrated programs by women of the general population is lacking. We analyzed program operations data from the Cervical Cancer Prevention Program in Zambia (CCPPZ), the largest public sector programs of its kind in sub-Saharan Africa. We evaluated patterns of utilization of screening services by HIV serostatus, examined contemporaneous trends in screening outcomes, and used multivariable modeling to identify factors associated with screening test positivity. Between January 2006 and April 2011, CCPPZ services were utilized by 56,247 women who underwent cervical cancer screening with visual inspection with acetic acid (VIA), aided by digital cervicography. The proportion of women accessing these services who were HIV-seropositive declined from 54% to 23% between 2006-2010, which coincided with increasing proportions of HIV-seronegative women (from 22% to 38%) and women whose HIV serostatus was unknown (from 24% to 39%) (all p-for trend<0.001). The rates of VIA screening positivity declined from 47% to 17% during the same period (p-for trend <0.001), and this decline was consistent across all HIV serostatus categories. After adjusting for demographic and sexual/reproductive factors, HIV-seropositive women were more than twice as likely (Odds ratio 2.62, 95% CI 2.49, 2.76) to screen VIA-positive than HIV-seronegative women. This is the first 'real world' demonstration in a public sector implementation program in a sub-Saharan African setting that with successful program scale-up efforts, nurse-led cervical cancer screening programs targeting women with HIV can expand and serve all women, regardless of HIV serostatus. Screening program performance can

  17. Prostate cancer screening in a healthy population cohort in eastern Nepal: an explanatory trial study.

    Science.gov (United States)

    Belbase, Narayan Prasad; Agrawal, Chandra Shekhar; Pokharel, Paras Kumar; Agrawal, Sudha; Lamsal, Madhab; Shakya, Vikal Chandra

    2013-01-01

    Prostate cancer features a substantial incidence and mortality burden, similarly to breast cancer, and it ranks among the top ten specific causes of death in males. To explore the situation of prostate cancer in a healthy population cohort in Eastern Nepal. This study was conducted in the Department of General Surgery at B. P. Koirala Institute of Health Sciences, Dharan, Nepal from July 2010 to June 2011. Males above 50 years visiting the Surgical Outpatient Department in BPKIHS were enrolled in the study and screening camps were organized in four Teaching District Hospitals of BPKIHS, all in Eastern Nepal. Digital rectal examination (DRE) was conducted by trained professionals after collecting blood for assessment of serum prostatic specific antigen (PSA). Trucut biopsies were performed for all individuals with abnormal PSA/DRE findings. A total of 1,521 males more than 50 years of age were assessed and screened after meeting the inclusion criteria. The vast majority of individuals, 1,452 (96.2%), had PSA ≤4.0 ng/ml. Abnormal PSA (>4 ng/ml) was found in 58 (3.8%). Abnormal DRE was found in 26 (1.72%). DRE and PSA were both abnormal in 26 (1.72%) individuals. On the basis of raised PSA or abnormal DRE 58 (3.84%) individuals were subjected to digitally guided trucut biopsy. Biopsy report revealed benign prostatic hyperplasia in 47 (3.11%) and adenocarcinoma prostate in 11 (0.73%). The specificity of DRE was 66.0%with a sensitivity of 90.9% and a positive predictive value of 38.5%. The sensitivity of PSA more than 4ng/ml in detecting carcinoma prostate was 100% and the positive predictive value for serum PSA was 19.0% The overall cancer detection rate in this study was 0.73% and those detected were locally advanced. Larger community-based studies are highly warranted specially among high-risk groups.

  18. Cervical cancer screening: knowledge, health perception and attendance rate among Hong Kong Chinese women

    Directory of Open Access Journals (Sweden)

    Sharron SK Leung

    2010-07-01

    Full Text Available Sharron SK Leung1, Ivy Leung21School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong; 2Quality Healthcare Medical Services, Hong KongPurpose: Cervical cancer screening has been consistently shown to be effective in reducing the incidence rate and mortality from cervical cancer. However, cervical screening attendance rates are still far from satisfactory in many countries. Strategies, health promotion and education programs need to be developed with clear evidence of the causes and factors relating to the low attendance rate. The study aims to assess the prediction of cervical screening attendance rate by Chinese women’s knowledge about cervical cancer and cervical screening as well as their perception of health.Patients and methods: A survey with self-reported questionnaires was conducted on 385 Chinese women recruited from a community clinic in Hong Kong. Participants were Chinese women, Hong Kong residents, aged 18–65 years, able to read Chinese or English, and were not pregnant.Results: Women aged 37 years or less, with at least tertiary education, who perceived having control over their own health and had better knowledge on risk factors, were more likely to attend cervical cancer screening. Many participants had adequate general knowledge but were unable to identify correct answers on the risk factors.Conclusion: Health promotion efforts need to focus on increasing women’s knowledge on risk factors and enhancing their perceived health control by providing more information on the link between screening and early detection with lower incidence rates and mortality from cervical cancer.Keywords: cervical screening attendance, cervical cancer, health perception and knowledge, perceived health control, Chinese

  19. Screening for Prostate Cancer Starting at Age 50-54 Years. A Population-based Cohort Study.

    Science.gov (United States)

    Carlsson, Sigrid; Assel, Melissa; Ulmert, David; Gerdtsson, Axel; Hugosson, Jonas; Vickers, Andrew; Lilja, Hans

    2017-01-01

    Current prostate cancer screening guidelines conflict with respect to the age at which to initiate screening. To evaluate the effect of prostate-specific antigen (PSA) screening versus zero screening, starting at age 50-54 yr, on prostate cancer mortality. This is a population-based cohort study comparing 3479 men aged 50 yr through 54 yr randomized to PSA-screening in the Göteborg population-based prostate cancer screening trial, initiated in 1995, versus 4060 unscreened men aged 51-55 yr providing cryopreserved blood in the population-based Malmö Preventive Project in the pre-PSA era, during 1982-1985. Cumulative incidence and incidence rate ratios of prostate cancer diagnosis, metastasis, and prostate cancer death. At 17 yr, regular PSA-screening in Göteborg of men in their early 50s carried a more than two-fold higher risk of prostate cancer diagnosis compared with the unscreened men in Malmö (incidence rate ratio [IRR] 2.56, 95% confidence interval [CI] 2.18, 3.02), but resulted in a substantial decrease in the risk of metastases (IRR 0.43, 95% CI 0.22, 0.79) and prostate cancer death (IRR 0.29, 95% CI 0.11, 0.67). There were 57 fewer prostate cancer deaths per 10000 men (95% CI 22, 92) in the screened group. At 17 yr, the number needed to invite to PSA-screening and the number needed to diagnose to prevent one prostate cancer death was 176 and 16, respectively. The study is limited by lack of treatment information and the comparison of the two different birth cohorts. PSA screening for prostate cancer can decrease prostate cancer mortality among men aged 50-54 yr, with the number needed to invite and number needed to detect to prevent one prostate cancer death comparable to those previously reported from the European Randomized Study of Screening for Prostate Cancer for men aged 55-69 yr, at a similar follow-up. Guideline groups could consider whether guidelines for PSA screening should recommend starting no later than at ages 50-54 yr. Guideline

  20. The ESA Planetary Science Archive User Group (PSA-UG)

    Science.gov (United States)

    Pio Rossi, Angelo; Cecconi, Baptiste; Fraenz, Markus; Hagermann, Axel; Heather, David; Rosenblatt, Pascal; Svedhem, Hakan; Widemann, Thomas

    2014-05-01

    ESA has established a Planetary Science Archive User Group (PSA-UG), with the task of offering independent advice to ESA's Planetary Science Archive (e.g. Heather et al., 2013). The PSA-UG is an official and independent body that continuously evaluates services and tools provided by the PSA to the community of planetary data scientific users. The group has been tasked with the following top level objectives: a) Advise ESA on future development of the PSA. b) Act as a focus for the interests of the scientific community. c) Act as an advocate for the PSA. d) Monitor the PSA activities. Based on this, the PSA-UG will report through the official ESA channels. Disciplines and subjects represented by PSA-UG members include: Remote Sensing of both Atmosphere and Solid Surfaces, Magnetospheres, Plasmas, Radio Science and Auxilliary data. The composition of the group covers ESA missions populating the PSA both now and in the near future. The first members of the PSA-UG were selected in 2013 and will serve for 3 years, until 2016. The PSA-UG will address the community through workshops, conferences and the internet. Written recommendations will be made to the PSA coordinator, and an annual report on PSA and the PSA-UG activities will be sent to the Solar System Exploration Working Group (SSEWG). Any member of the community and planetary data user can get in touch with individual members of the PSA-UG or with the group as a whole via the contacts provided on the official PSA-UG web-page: http://archives.esac.esa.int/psa/psa-ug. The PSA is accessible via: http://archives.esac.esa.int/psa References: Heather, D., Barthelemy, M., Manaud, N., Martinez, S., Szumlas, M., Vazquez, J. L., Osuna, P. and the PSA Development Team (2013) ESA's Planetary Science Archive: Status, Activities and Plans. EuroPlanet Sci. Congr. #EPSC2013-626

  1. Obesity and Cancer Screening according to Race and Gender

    Directory of Open Access Journals (Sweden)

    Heather Bittner Fagan

    2011-01-01

    Full Text Available The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC screening, the relationship between weight and screening in men is inconsistent, while there is a trend towards lower CRC screening in higher weight women.

  2. Prostate cancer incidence rates have started to decrease in central Italy.

    Science.gov (United States)

    Crocetti, Emanuele; Ciatto, Stefano; Buzzoni, Carlotta; Zappa, Marco

    2010-01-01

    The widespread use of prostate-specific antigen (PSA) testing has dramatically changed the epidemiology of prostate cancer. Growing incidence rates have been documented in almost all western countries following the increased usage of PSA screening. In the United States after a period of huge increase in incidence, rates have decreased to values lower than those of the pre-PSA era. Similar changes have been documented also in the area of the Tuscany Cancer Registry, central Italy, where prostate cancer incidence rates doubled from the early 1990s to 2003 and afterwards decreased. This is the first evidence, to our knowledge, of a decline in prostate cancer incidence in Italy following the screening-related increase.

  3. Do Racial Disparities Exist in the Use of Prostate Cancer Screening and Detection Tools in Veterans?

    Science.gov (United States)

    Hudson, M’Liss A.; Luo, Suhong; Chrusciel, Timothy; Yan, Yan; Grubb, Robert L.; Carson, Kenneth; Scherrer, Jeffrey F.

    2014-01-01

    Objective To determine whether racial disparities exist in the use of prostate cancer screening and detection tools in veterans. Methods and Materials Administrative data was obtained from the Corporate Data Warehouse on a national cohort of 275,831 veterans (21% AA) ages 40–70 years who were free of heart disease, an elevated PSA level (> 4.0 ng/mL), other clinical signs of prostate cancer, prostate cancer diagnosis, and treatment for prostate cancer between 10/1/1998 – 9/30/2000. Subjects were followed until 9/30/2007. Regular users were defined as those with at least one annual visit to the Veterans Healthcare Administration (VHA) between 10/1/1998 and 9/30/2000. We sought to determine if race was significantly associated with PSA testing, time to elevated PSA detection, time to prostate biopsy and time to diagnosis of prostate cancer. Chi square tests, logistic regression and Cox proportional hazard models were used to test for associations between race and prostate cancer variables. Results 84% of veterans ages 40–70 years undergo PSA testing. AA veterans are as likely as white veterans to undergo PSA testing. Screened AA veterans are more likely to have a PSA > 4 ng/mL, undergo prostate biopsy and be diagnosed with prostate cancer than screened white veterans. The time intervals to undergoing a prostate biopsy and being diagnosed with prostate cancer were statistically significantly shorter (although unlikely of clinical significance) for AA veterans with a PSA level > 4 ng/mL than that for white veterans with a PSA level > 4 ng/mL. When routine care in regular VHA users was compared to that of participants in major screening trials such as Prostate, Lung, Ovarian and Colon Cancer (PLCO) Trial and European Study of Screening for Prostate Cancer (ERSPC), prostate biopsy rates were lower (30% versus 40–86%), prostate cancer detection rates/person biopsied were higher (49% versus 31–45%), and incidence of prostate cancer was 1.1% versus 4.9–8

  4. Do racial disparities exist in the use of prostate cancer screening and detection tools in veterans?

    Science.gov (United States)

    Hudson, M'Liss A; Luo, Suhong; Chrusciel, Timothy; Yan, Yan; Grubb, Robert L; Carson, Kenneth; Scherrer, Jeffrey F

    2014-01-01

    To determine whether racial disparities exist in the use of prostate cancer screening and detection tools in veterans. Administrative data were obtained from the Corporate Data Warehouse on a national cohort of 275,831 veterans (21% African American [AA]) between the ages of 40 and 70 years who were free of heart disease, did not have an elevated prostate specific antigen (PSA) level (>4 ng/ml), did not have other clinical signs of prostate cancer, had not been diagnosed with prostate cancer, and had not received treatment for prostate cancer between January 10, 1998 and September 30, 2000. Subjects were followed up until September 30, 2007. Regular users were defined as those with at least 1 annual visit to the Veterans Healthcare Administration (VHA) between October 1, 1998 and September 30, 2000. We sought to determine if race was significantly associated with PSA testing, the time to elevated PSA detection, the time to prostate biopsy, and the time to diagnosis of prostate cancer. Chi-square tests, logistic regression, and Cox proportional hazard models were used to test for associations between race and prostate cancer variables. Eighty-four percent of the veterans between the ages 40 and 70 years undergo PSA testing. AA veterans are as likely as white veterans to undergo PSA testing. Screened AA veterans are more likely to have a PSA>4 ng/ml, undergo prostate biopsy, and be diagnosed with prostate cancer than screened white veterans. The time intervals between undergoing a prostate biopsy and being diagnosed with prostate cancer were statistically significantly shorter (although unlikely of clinical significance) for AA veterans with a PSA level>4 ng/ml than that for white veterans with a PSA level>4 ng/ml. When routine care in regular VHA users was compared with that of participants in major screening trials such as Prostate, Lung, Ovarian and Colon Cancer Trial and European Study of Screening for Prostate Cancer, prostate biopsy rates were lower (30% vs. 40

  5. Obesity inversely correlates with prostate-specific antigen levels in a population with normal screening results of prostate cancer in northwestern China.

    Science.gov (United States)

    Zhang, J; Ma, M; Nan, X; Sheng, B

    2016-07-11

    Serum prostate-specific antigen (PSA) is a diagnostic biomarker of prostate cancer and is possibly associated with obesity. This study aimed to explore the relationships between obesity indicators [body mass index (BMI) and waist circumference (WC)] with PSA in Chinese men. A cross-sectional study of men aged 30-85 years undergoing prostate cancer screening was conducted from August 2008 to July 2013 in Xi'an, China. Data were obtained from clinical reports, condition was recorded based on self-report including demographics, weight, height, and WC (>90 cm=obese). Fasting blood glucose (FBG) and prostate volume (PV) were assessed clinically. Patients were grouped by BMI (normal=22.9, overweight=23-27.4, obese≥27.5 kg/m2). PSA parameters of density (PSAD), PSA serum level, and PSA increasing rate per year (PSAR) were calculated per BMI and age groups (30-40, 41-59, 60-85 years). Obesity indicators (BMI and WC) and PSA parameter relationships were modeled by age-stratified linear regression. Of 35,632 Chinese men surveyed, 13,084 were analyzed, including 13.44% obese, 57.44% overweight, and 29.12% normal weight, according to BMI; 25.84% were centrally (abdominally) obese according to WC. BMI and WC were negatively associated with all PSA parameters, except PSAD and PSAR [Pobesity was associated with lower PSA in Chinese men. Therefore, an individual's BMI and WC should be considered when PSA is used to screen for prostate cancer.

  6. Obesity inversely correlates with prostate-specific antigen levels in a population with normal screening results of prostate cancer in northwestern China

    Directory of Open Access Journals (Sweden)

    J. Zhang

    2016-01-01

    Full Text Available Serum prostate-specific antigen (PSA is a diagnostic biomarker of prostate cancer and is possibly associated with obesity. This study aimed to explore the relationships between obesity indicators [body mass index (BMI and waist circumference (WC] with PSA in Chinese men. A cross-sectional study of men aged 30-85 years undergoing prostate cancer screening was conducted from August 2008 to July 2013 in Xi'an, China. Data were obtained from clinical reports, condition was recorded based on self-report including demographics, weight, height, and WC (>90 cm=obese. Fasting blood glucose (FBG and prostate volume (PV were assessed clinically. Patients were grouped by BMI (normal=22.9, overweight=23-27.4, obese≥27.5 kg/m2. PSA parameters of density (PSAD, PSA serum level, and PSA increasing rate per year (PSAR were calculated per BMI and age groups (30-40, 41-59, 60-85 years. Obesity indicators (BMI and WC and PSA parameter relationships were modeled by age-stratified linear regression. Of 35,632 Chinese men surveyed, 13,084 were analyzed, including 13.44% obese, 57.44% overweight, and 29.12% normal weight, according to BMI; 25.84% were centrally (abdominally obese according to WC. BMI and WC were negatively associated with all PSA parameters, except PSAD and PSAR [P<0.05, BMI: β=-0.081 (95%CI=-0.055 to -0.036, WC: β=-0.101 (-0.021 to -0.015], and independent of FBG and PV (P<0.05 in an age-adjusted model. In conclusion, obesity was associated with lower PSA in Chinese men. Therefore, an individual's BMI and WC should be considered when PSA is used to screen for prostate cancer.

  7. Looking at reality versus watching screens: Media professionalization effects on the spontaneous eyeblink rate.

    Directory of Open Access Journals (Sweden)

    Celia Andreu-Sánchez

    Full Text Available This article explores whether there are differences in visual perception of narrative between theatrical performances and screens, and whether media professionalization affects visual perception. We created a live theatrical stimulus and three audio-visual stimuli (each one with a different video editing style having the same narrative, and displayed them randomly to participants (20 media professionals and 20 non-media professionals. For media professionals, watching movies on screens evoked a significantly lower spontaneous blink rate (SBR than looking at theatrical performances. Media professionals presented a substantially lower SBR than non-media professionals when watching screens, and more surprisingly, also when seeing reality. According to our results, media professionals pay higher attention to both screens and the real world than do non-media professionals.

  8. Looking at reality versus watching screens: Media professionalization effects on the spontaneous eyeblink rate.

    Science.gov (United States)

    Andreu-Sánchez, Celia; Martín-Pascual, Miguel Ángel; Gruart, Agnès; Delgado-García, José María

    2017-01-01

    This article explores whether there are differences in visual perception of narrative between theatrical performances and screens, and whether media professionalization affects visual perception. We created a live theatrical stimulus and three audio-visual stimuli (each one with a different video editing style) having the same narrative, and displayed them randomly to participants (20 media professionals and 20 non-media professionals). For media professionals, watching movies on screens evoked a significantly lower spontaneous blink rate (SBR) than looking at theatrical performances. Media professionals presented a substantially lower SBR than non-media professionals when watching screens, and more surprisingly, also when seeing reality. According to our results, media professionals pay higher attention to both screens and the real world than do non-media professionals.

  9. [Attendance rate in the Polish Cervical Cancer Screening Program in the years 2007-2009].

    Science.gov (United States)

    Spaczyński, Marek; Karowicz-Bilinska, Agata; Rokita, Wojciech; Molińska-Glura, Marta; Januszek-Michalecka, Lucyna; Seroczyński, Przemysław; Uchlik, Joanna; Nowak-Markwitz, Ewa

    2010-09-01

    In Poland in 2007, according to the National Cancer Registry 3431 women were diagnosed with cervical cancer and 1907 died. To change the unfavorable epidemiologic situation, in 2005 the Ministry of Health (MH), the National Health Fund (NHF) and the Polish Gynecological Society following WHO/IARC guidelines developed a National Population-Based Cervical Cancer Screening Program. Its implementation and roll-out started in 2006. The target population are women aged 25 to 59 insured in the National Health Fund. A Pap test is done with a three-year interval, free of charge. The system is based on personal invitations sent by regular post. Invitation to screening is supported by a social educational campaign "Choose Life" run under one slogan and logo across the whole country The NHF data base enables identification of women to screen. Pap smears are collected by gynecologists and since 2008 also by midwives trained and certified by the Program National Coordinating Center Pap test results are reported in the Bethesda 2001 system. The Screening Program has its system of quality assurance and control and is supported by a specially designed computer data base called SIMP (System of Information Monitoring in Prophylaxis) with online access to all records. In addition to organized, population-based screening there is also opportunistic screening in Poland practiced either by private gynecological practices or by some units that cooperate with the National Health Fund, but do Pap tests as an element of comprehensive gynecological examination. Those smears are not registered in the SIMP. Our aim was analysis of attendance rate in the Cervical Cancer Screening Program in the years 2007-2009. We also investigated correlation between screening coverage and invitation sending schedule, as well as between coverage and screening accessibility determined by the number of gynaecological practices where Pap smears are collected. Attendance rate in the Screening Program was evaluated

  10. Cancer - What You Don't Know Can Kill You PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-07-22

    This 60 second PSA is based on the July 2010 CDC Vital Signs report which provides information on colorectal and breast cancer and the importance of getting screened.  Created: 7/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/22/2010.

  11. Should baseline PSA testing be performed in men aged 40 to detect ...

    African Journals Online (AJOL)

    Objective. We aimed to evaluate the presenting features and treatment outcome of prostate cancer in men aged <50 years, in a region where prostate specific antigen (PSA) screening is not readily available and most men present with symptoms. Methods. We analysed the data of 1 571 men with prostatic adenocarcinoma ...

  12. Cost and detection rate of glaucoma screening with imaging devices in a primary care center

    Directory of Open Access Journals (Sweden)

    Anton A

    2017-02-01

    Full Text Available Alfonso Anton,1–4 Monica Fallon,3,5 Francesc Cots,2 María A Sebastian,6 Antonio Morilla-Grasa,4 Sergi Mojal,3 Xavier Castells2 1Medicine School, Universidad Internacional de Cataluña, 2Servei d’Estudies, Parc de Salut Mar, 3Instituto Hospital del Mar de Investigaciones Médicas (IMIM, 4Glaucoma Department, Instituto Catalán de Retina (ICR, 5Universidad Autónoma de Barcelona, 6Centro de Atención Primaria Larrard, Barcelona, Spain Purpose: To analyze the cost and detection rate of a screening program for detecting glaucoma with imaging devices. Materials and methods: In this cross-sectional study, a glaucoma screening program was applied in a population-based sample randomly selected from a population of 23,527. Screening targeted the population at risk of glaucoma. Examinations included optic disk tomography (Heidelberg retina tomograph [HRT], nerve fiber analysis, and tonometry. Subjects who met at least 2 of 3 endpoints (HRT outside normal limits, nerve fiber index ≥30, or tonometry ≥21 mmHg were referred for glaucoma consultation. The currently established (“conventional” detection method was evaluated by recording data from primary care and ophthalmic consultations in the same population. The direct costs of screening and conventional detection were calculated by adding the unit costs generated during the diagnostic process. The detection rate of new glaucoma cases was assessed. Results: The screening program evaluated 414 subjects; 32 cases were referred for glaucoma consultation, 7 had glaucoma, and 10 had probable glaucoma. The current detection method assessed 677 glaucoma suspects in the population, of whom 29 were diagnosed with glaucoma or probable glaucoma. Glaucoma screening and the conventional detection method had detection rates of 4.1% and 3.1%, respectively, and the cost per case detected was 1,410 and 1,435€, respectively. The cost of screening 1 million inhabitants would be 5.1 million euros and would allow

  13. Impacts of the Finnish service screening programme on breast cancer rates

    Directory of Open Access Journals (Sweden)

    Hakulinen Timo

    2008-01-01

    Full Text Available Abstract Background The aim of the current study was to examine impacts of the Finnish breast cancer (BC screening programme on the population-based incidence and mortality rates. The programme has been historically targeted to a rather narrow age band, mainly women of ages 50–59 years. Methods The study was based on the information on breast cancer during 1971–2003 from the files of the Finnish Cancer Registry. Incidence, cause-specific mortality as well as incidence-based (refined mortality from BC were analysed with Poisson regression. Age-specific incidence and routine cause-specific mortality were estimated for the most recent five-year period available; incidence-based mortality, respectively, for the whole steady state of the programme, 1992–2003. Results There was excess BC incidence with actual screening ages; incidence in ages 50–69 was increased 8% (95 CI 2.9–13.4. There was an increasing temporal tendency in the incidence of localised BC; and, respectively, a decrease in that of non-localised BC. The latter was most consistent in age groups where screening had been on-going several years or eventually after the last screen. The refined mortality rate from BC diagnosed in ages 50–69 was decreased with -11.1% (95% CI -19.4, -2.1. Conclusions The current study demonstrates that BC screening in Finland is effective in reducing mortality rates from breast cancers, even though the impact on the population level is smaller than expected based on the results from randomised trials among women screened in age 50 to 69. This may be explained by the rather young age group targeted in our country. Consideration whether to targeted screening up to age 69 is warranted.

  14. REVIEW ARTICLE: PROSTATE CANCER SCREENING USING ...

    African Journals Online (AJOL)

    FOBUR

    ABSTRACT. Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with ...

  15. A national multicenter phase 2 study of prostate-specific antigen (PSA) pox virus vaccine with sequential androgen ablation therapy in patients with PSA progression: ECOG 9802.

    Science.gov (United States)

    DiPaola, Robert S; Chen, Yu-Hui; Bubley, Glenn J; Stein, Mark N; Hahn, Noah M; Carducci, Michael A; Lattime, Edmund C; Gulley, James L; Arlen, Philip M; Butterfield, Lisa H; Wilding, George

    2015-09-01

    E9802 was a phase 2 multi-institution study conducted to evaluate the safety and effectiveness of vaccinia and fowlpox prostate-specific antigen (PSA) vaccine (step 1) followed by combination with androgen ablation therapy (step 2) in patients with PSA progression without visible metastasis. To test the hypothesis that vaccine therapy in this early disease setting will be safe and have a biochemical effect that would support future studies of immunotherapy in patients with minimal disease burden. Patients who had PSA progression following local therapy were treated with PROSTVAC-V (vaccinia)/TRICOM on cycle 1 followed by PROSTVAC-F (fowlpox)/TRICOM for subsequent cycles in combination with granulocyte-macrophage colony-stimulating factor (step 1). Androgen ablation was added on progression (step 2). Step 1 primary end points included progression at 6 mo and characterization of change in PSA velocity pretreatment to post-treatment. Step 2 end points included PSA response with combined vaccine and androgen ablation. In step 1, 25 of 40 eligible patients (63%) were progression free at 6 mo after registration (90% confidence interval [CI], 48-75). The median pretreatment PSA velocity was 0.13 log(PSA)/mo, in contrast to median postregistration velocity of 0.09 log(PSA)/mo (p=0.02), which is an increase in median PSA doubling time from 5.3 mo to 7.7 mo. No grade ≥4 treatment-related toxicity was observed. In the 27 patients eligible and treated for step 2, 20 patients achieved a complete response (CR) at 7 mo (CR rate: 74%; 90% CI, 57-87). Although supportive of larger studies in the cooperative group setting, this study is limited by the small number of patients and the absence of a control group as in a phase 3 study. A viral PSA vaccine can be administered safely in the multi-institutional cooperative group setting to patients with minimal disease volume alone and combined with androgen ablation, supporting the feasibility of future phase 3 studies in this

  16. the discriminative ability of percent free psa in patients with psa > 10 ...

    African Journals Online (AJOL)

    pathology revealed by sextant biopsy under transrectal ultrasound (TRUS) guidance using a 7.5 MHz probe (Panther®, B & K, Denmark). Indications for biopsy were: a PSA > 4 ng/ ml, a suspicious prostatic nodule on digital rectal examination (DRE) and a hypoechoic area on. TRUS. Total and free PSA were assessed us-.

  17. The effect on the sensitivities of PSA and PSA-age volume score of ...

    African Journals Online (AJOL)

    O. Üçer

    2017-04-27

    Apr 27, 2017 ... Conclusions: All our data shows that if we remove most of the factors which effect PSA such as age, prostate volume, prostatitis and BPH, we may increase the sensitivity of PSA for predicting positive prostate biopsy. ... Peer review under responsibility of Pan African Urological Surgeons' Association.

  18. Contribution of screening and survival differences to racial disparities in colorectal cancer rates

    NARCIS (Netherlands)

    I. Lansdorp-Vogelaar (Iris); K.M. Kuntz (Karen); A.B. Knudsen (Amy); M. van Ballegooijen (Marjolein); A. Zauber (Ann); A. Jemal (Ahmedin)

    2012-01-01

    textabstractBackground: Considerable disparities exist in colorectal cancer (CRC) incidence and mortality rates between blacks and whites in the United States. We estimated how much of these disparities could be explained by differences in CRC screening and stage-specific relative CRC survival.

  19. Rates of formal diagnosis of dementia in primary care: The effect of screening.

    Science.gov (United States)

    Eichler, Tilly; Thyrian, Jochen René; Hertel, Johannes; Michalowsky, Bernhard; Wucherer, Diana; Dreier, Adina; Kilimann, Ingo; Teipel, Stefan; Hoffmann, Wolfgang

    2015-03-01

    Screening could improve recognition of dementia in primary care. We sought to determine the effect of screening for dementia in primary care practices on the formal diagnosis rate; the distribution of differential diagnoses; and the factors associated with receiving a formal diagnosis. The "Dementia: life- and person-centered help in Mecklenburg-Western Pomerania" is an ongoing general practitioner (GP)-based, randomized, controlled intervention trial. A total of 4064 community dwelling patients (aged ≥70 years) were screened for dementia in 108 GP practices. Of these patients, 692 (17%) had positive screening results (DemTect score informed consent. The analyses included the data from 243 patients with a complete baseline assessment (preliminary data; January 2014). Of 146 patients without a formal diagnosis of dementia, 72 (49%) received a formal diagnosis after a positive screening outcome (69% with "unspecified dementia"). Female sex was significantly associated with receiving a formal diagnosis (multivariate analyses). Screening improved the identification of dementia considerably. Because of the risk of receiving a false-positive diagnosis, additional diagnostic assessment should be mandatory.

  20. Depression Screening Using Daily Mental-Health Ratings from a Smartphone Application for Breast Cancer Patients.

    Science.gov (United States)

    Kim, Junetae; Lim, Sanghee; Min, Yul Ha; Shin, Yong-Wook; Lee, Byungtae; Sohn, Guiyun; Jung, Kyung Hae; Lee, Jae-Ho; Son, Byung Ho; Ahn, Sei Hyun; Shin, Soo-Yong; Lee, Jong Won

    2016-08-04

    Mobile mental-health trackers are mobile phone apps that gather self-reported mental-health ratings from users. They have received great attention from clinicians as tools to screen for depression in individual patients. While several apps that ask simple questions using face emoticons have been developed, there has been no study examining the validity of their screening performance. In this study, we (1) evaluate the potential of a mobile mental-health tracker that uses three daily mental-health ratings (sleep satisfaction, mood, and anxiety) as indicators for depression, (2) discuss three approaches to data processing (ratio, average, and frequency) for generating indicator variables, and (3) examine the impact of adherence on reporting using a mobile mental-health tracker and accuracy in depression screening. We analyzed 5792 sets of daily mental-health ratings collected from 78 breast cancer patients over a 48-week period. Using the Patient Health Questionnaire-9 (PHQ-9) as the measure of true depression status, we conducted a random-effect logistic panel regression and receiver operating characteristic (ROC) analysis to evaluate the screening performance of the mobile mental-health tracker. In addition, we classified patients into two subgroups based on their adherence level (higher adherence and lower adherence) using a k-means clustering algorithm and compared the screening accuracy between the two groups. With the ratio approach, the area under the ROC curve (AUC) is 0.8012, indicating that the performance of depression screening using daily mental-health ratings gathered via mobile mental-health trackers is comparable to the results of PHQ-9 tests. Also, the AUC is significantly higher (P=.002) for the higher adherence group (AUC=0.8524) than for the lower adherence group (AUC=0.7234). This result shows that adherence to self-reporting is associated with a higher accuracy of depression screening. Our results support the potential of a mobile mental

  1. First trimester ultrasound screening is effective in reducing postterm labor induction rates: a randomized controlled trial.

    Science.gov (United States)

    Bennett, Kelly A; Crane, Joan M G; O'shea, Patrick; Lacelle, Joanne; Hutchens, Donna; Copel, Joshua A

    2004-04-01

    This study was designed to test the null hypothesis that first trimester ultrasound crown-rump length measurement for gestational age determination will result in no difference in the rate of induction of labor for postterm pregnancy, compared with second trimester biometry alone. Two hundred eighteen women were randomly assigned to receive either first trimester ultrasound screening or second trimester ultrasound screening to establish the expected date of confinement. Sample size was calculated by using a 2-tailed alpha=.05 and power (1-beta)=80%. Data were analyzed with chi(2) and Fisher exact tests. Of 104 women randomly assigned to the first trimester screening group, 41.3% had their gestational age adjusted on the basis of the crown-rump length measurement. Of 92 women randomly assigned to the second trimester screening group, 10.9% were corrected as a result of biometry (P postterm pregnancy (P=0.04, relative risk=0.37, 95% CI=0.14-0.96). The application of a program of first trimester ultrasound screening to a low-risk obstetric population results in a significant reduction in the rate of labor induction for postterm pregnancy.

  2. [Dairy cattle pregnancy rate in fixed time artificial insemination program with and without ultrasonic gynecologic screening.

    Directory of Open Access Journals (Sweden)

    Gustavo Fernandes Grillo

    2016-06-01

    Full Text Available To evaluate the pregnancy rate and the importance of ultrasound gynecological screening (US performed prior to fixed time artificial insemination programs (TAI, 120 Girolando cows, over two breeding seasons (2013 and 2014, were divided into two groups: (C / T; n = 58 and without (S / T; n = 62 gynecological screening by ultrasound, using three protocols, and the same for the groups with and without screening. Protocol I - “OvSynch” (OV in which received 0.025 mg of buserelin acetate in D0; 0.15 mg d-cloprostenol on D7; 0.025 mg buserelin acetate D9; It is inseminated at fixed time in D10. Protocol II - “OvSynch” + progesterone (OP4 and III Protocol - “OvSynch” + LH + P4 (OP4LH. Protocols II and III followed the same dosages of “OvSynch” associated with the introduction of intravaginal device containing 1g first use of progesterone in D0 and D7 in withdrawal. In Protocol III, LH replaced buserelin acetate in ovulation induction (D9; 25mg. Gestation diagnosis was made by US 45 days after TAI, and the animals not pregnant were reinseminated as presented heat. Parameters pregnancy rate at TAI (TP, total pregnancy rate (TPT = TAI + Return heat were analyzed by Chi-square or Fisher’s exact with 5% significance level. The use of progesterone favored the pregnancy rate of cyclic and acyclic animals, this has not occurred with LH job as ovulation inductor, providing no increase in pregnancy rates and overall pregnancy rate of dairy cows referred to the rated protocol. The gynecological screening by ultrasonography allowed evaluating the cyclicity of the studied females, indicating that its previous execution to the TAI, can provide good results with the use of better efficiency protocols for TAI programs.

  3. Longitudinal Rates of Colon Cancer Screening Use in Winnipeg, Canada: The Experience of a Universal Health-Care System with an Organized Colon Screening Program.

    Science.gov (United States)

    Decker, Kathleen M; Demers, Alain A; Nugent, Zoann; Biswanger, Natalie; Singh, Harminder

    2015-12-01

    We examined trends in colorectal cancer (CRC) screening (fecal occult blood test (FOBT), colonoscopy, and flexible sigmoidoscopy (FS)) and differences in CRC screening by income in a population with an organized CRC screening program and universal health-care coverage. Individuals who had an FOBT, colonoscopy, or FS were identified from the provincial Physician Claims database and the population-based colon cancer screening registry. Trends in age-standardized rates were determined. Logistic regression was performed to explore the association between CRC screening and income quintiles by year. Up-to-date CRC screening (FOBT, colonoscopy, or FS) increased over time for men and women, all age groups, and all income quintiles. Up-to-date CRC screening was very high among 65- to 69- and 70- to 74-year-olds (70% and 73%, respectively). There was a shift toward the use of an FOBT for CRC screening for individuals in the lower income quintiles. The disparity in colonoscopy/FS coverage by income quintile was greater in 2012 than in 1995. Overall, there was no reduction in disparities by income in up-to-date CRC screening nor did the rate of increase in up-to-date CRC screening or FOBT use change after the introduction of the organized provincial CRC screening program. CRC screening is increasing over time for both men and women and all age groups. However, a disparity in up-to-date CRC screening by income persisted even with an organized CRC screening program in a universal health-care setting.

  4. Reduction in interval cancer rates following the introduction of two-view mammography in the UK breast screening programme.

    Science.gov (United States)

    Dibden, A; Offman, J; Parmar, D; Jenkins, J; Slater, J; Binysh, K; McSorley, J; Scorfield, S; Cumming, P; Liao, X-H; Ryan, M; Harker, D; Stevens, G; Rogers, N; Blanks, R; Sellars, S; Patnick, J; Duffy, S W

    2014-02-04

    The introduction of two-view mammography at incident (subsequent) screens in the National Health Service Breast Screening Programme (NHSBSP) has led to an increased number of cancers detected at screen. However, the effect of two-view mammography on interval cancer rates has yet to be assessed. Routine screening and interval cancer data were collated from all screening programmes in the United Kingdom for women aged 50-64, screened between 1 April 2003 and 31 March 2005. Interval cancer rates were compared based on whether two-view mammography was in use at the last routine screen. The reduction in interval cancers following screening using two-view mammography compared with one view was 0.68 per 1,000 women screened. Overall, this suggests the introduction of two-view mammography at incident screen was accompanied by a 15-20% reduction in interval cancer rates in the NHSBSP. The introduction of two-view mammography at incident screens is associated with a reduction in incidence of interval cancers. This is consistent with previous publications on a contemporaneous increase in screen-detected cancers. The results provide further evidence of the benefit of the use of two-view mammography at incident screens.

  5. Insulin promotes cell migration by regulating PSA-NCAM

    Energy Technology Data Exchange (ETDEWEB)

    Monzo, Hector J.; Coppieters, Natacha [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Park, Thomas I.H. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dieriks, Birger V.; Faull, Richard L.M. [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Dragunow, Mike [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Pharmacology, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Curtis, Maurice A., E-mail: m.curtis@auckland.ac.nz [Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand); Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland (New Zealand)

    2017-06-01

    Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. - Highlights: • Insulin modulates PSA-NCAM turnover through upregulation of p-FAK. • P-FAK modulates αv-integrin/PSA-NCAM clustering. • αv-integrin acts as a carrier for PSA-NCAM endocytosis. • Cell migration is promoted by cell surface PSA. • Insulin promotes PSA-dependent migration in vitro.

  6. Is complementary and alternative medicine use associated with cancer screening rates for women with functional disabilities?

    Science.gov (United States)

    Suzuki, Rie; Eusebius, Small; Makled, Melissa

    2016-02-01

    The purpose of this study was to examine the associations of complementary and alternative medicine (CAM) use with mammogram and Pap test rates and functional disabilities (FDs). Cross-sectional study. Data were derived from the 2012 National Health Interview Survey (n=6576). FDs was defined as physical and/or social limitations. The weighted logistic regression models were performed using SAS software. Study covariates were age, race, education, marital status, usual source of care, and insurance. Of 6576 women, a majority were Caucasian (87%), with GED or less (40%), married (50%), having usual source of care (96%) and health insurance (91%), and with FDs (56%). The results indicated that some CAM practices were negatively associated with increased mammogram and Pap test rates while other CAM practices were positively associated. The results indicated that CAM practices that contribute to musculoskeletal problems such as acupuncture and massage were associated with the increased mammogram and Pap test rates. Contrary, women who used chiropractic manipulation, biofeedback, guided imagery, and energy hearing therapy were less likely to obtain cancer screenings regularly regardless of having FDs. The use of several CAM therapies was more likely to be associated with mammogram and Pap test frequency, indicating that the CAM use may be associated with better screening rates due to the improvement of musculoskeletal problems. It is important to determine how each CAM therapy improves secondary health conditions in clinical trials to increase cancer screening rates for women with FDs. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Effectiveness of introducing point of care capillary testing and linking screening with routine appointments for increasing blood lead screening rates of young children: a before-after study.

    Science.gov (United States)

    Boreland, Frances; Lyle, David; Brown, Anthony; Perkins, David

    2015-01-01

    Lead has significant neuro-toxic effects, particularly for young children. Voluntary screening of pre-school aged children for elevated blood lead levels has been an important part of the lead management program in the mining town of Broken Hill (NSW, Australia) since 1991, where lead remains a significant public health issue for young children despite average blood lead levels having fallen by two-thirds. The annual proportion of children screened declined to 0.39 in 2008. The objective of this study was to determine the impact of changing to capillary screening and linking screening with existing routine health programs on participation in blood lead screening by young children in the community. We used a before-after study. Screening rates were determined from routinely collected service data and analysed using cross-sectional and cohort analyses. The proportion of children screened annually increased from 0.39 in 2008 to 0.75 in 2012, with the greatest increases among 11-23 and 48-59 month old children. The proportion of children screened at least once by 24 months increased from 0.63 for children born in 2007 to 0.98 for children born in 2010. Attendance stabilized after capillary screening was introduced, and increased markedly after screening was offered at immunization. Changing from venous to capillary screening stabilized attendance and improving convenience was associated with dramatically increased screening. Linking screening with well-accepted mainstream child health programs is an effective strategy to improve participation in blood lead screening programs. The findings have implications for improving participation in other health screening programs.

  8. Cancer detection and cancer characteristics in the European Randomized Study of Screening for Prostate Cancer (ERSPC)--Section Rotterdam. A comparison of two rounds of screening.

    Science.gov (United States)

    Postma, Renske; Schröder, Fritz H; van Leenders, Geert J L H; Hoedemaeker, Robert F; Vis, Andre N; Roobol, Monique J; van der Kwast, Theodorus H

    2007-07-01

    To evaluate the features, rates, and characteristics of prostate cancer detected during two subsequent screening rounds. Data were retrieved from the database of European Randomized Study of Screening for Prostate Cancer (ERSPC), section Rotterdam. Men, ages 55-74 yr were screened with a 4-yr interval. Different biopsy indications were used in the first and second screens in the PSA range sextant biopsies were recorded for Gleason score and tumour extent, and 550 radical prostatectomy specimens were evaluated for Gleason score, pathologic T category, and tumour volume. Clinical stage, Gleason score, involvement of biopsy by tumour, and PSA levels were more favourable in patients of the second round compared with those of the first round. The number of men chosen for watchful waiting increased from 98 (10%) to 123 (22%) in the second round (pfirst and second screening round was 0.65 and 0.45 ml (p=0.001). Minimal cancer (cancer first and 60 (42.6%) in the second screening round (p=0.03). The 5-yr PSA progression-free survival after radical prostatectomy was 87%. Despite the 4-yr interval an important shift of all prognostic factors occurred in favour of round 2. In those men who underwent radical prostatectomy, 42.6% fulfilled the criteria of minimal cancer. These data suggest that overdiagnosis increases with repeat screening.

  9. A Cost-Utility Analysis of Prostate Cancer Screening in Australia.

    Science.gov (United States)

    Keller, Andrew; Gericke, Christian; Whitty, Jennifer A; Yaxley, John; Kua, Boon; Coughlin, Geoff; Gianduzzo, Troy

    2017-02-01

    The Göteborg randomised population-based prostate cancer screening trial demonstrated that prostate-specific antigen (PSA)-based screening reduces prostate cancer deaths compared with an age-matched control group. Utilising the prostate cancer detection rates from this study, we investigated the clinical and cost effectiveness of a similar PSA-based screening strategy for an Australian population of men aged 50-69 years. A decision model that incorporated Markov processes was developed from a health system perspective. The base-case scenario compared a population-based screening programme with current opportunistic screening practices. Costs, utility values, treatment patterns and background mortality rates were derived from Australian data. All costs were adjusted to reflect July 2015 Australian dollars (A$). An alternative scenario compared systematic with opportunistic screening but with optimisation of active surveillance (AS) uptake in both groups. A discount rate of 5 % for costs and benefits was utilised. Univariate and probabilistic sensitivity analyses were performed to assess the effect of variable uncertainty on model outcomes. Our model very closely replicated the number of deaths from both prostate cancer and background mortality in the Göteborg study. The incremental cost per quality-adjusted life-year (QALY) for PSA screening was A$147,528. However, for years of life gained (LYGs), PSA-based screening (A$45,890/LYG) appeared more favourable. Our alternative scenario with optimised AS improved cost utility to A$45,881/QALY, with screening becoming cost effective at a 92 % AS uptake rate. Both modelled scenarios were most sensitive to the utility of patients before and after intervention, and the discount rate used. PSA-based screening is not cost effective compared with Australia's assumed willingness-to-pay threshold of A$50,000/QALY. It appears more cost effective if LYGs are used as the relevant outcome, and is more cost effective than the

  10. Changes in prostate-specific antigen (PSA) level correlate with growth inhibition of prostate cancer cells treated in vitro with a novel anticancer drug, irofulven.

    Science.gov (United States)

    Woynarowska BAHigdon, A L; Muñoz, R M; Bushong, P; Waters, S J

    2001-01-01

    Irofulven (hydroxymethylacylfulvene, HMAF, MGI 114) is a novel agent with alkylating activity and a potent inducer of apoptosis. It is currently undergoing Phase II clinical trials for several tumor types, including hormone-refractory prostate cancer. Reduction of serum prostate-specific antigen (PSA) levels has been proposed as a generally useful endpoint for evaluating the antitumor efficacy of treatments for prostate cancer. However, the utility of PSA as a marker of tumor cell burden could be compromised, if drugs directly affected PSA secretion and/or expression. In these studies, we evaluated the effects of irofulven on PSA protein and mRNA levels during the course of treatment of prostate tumor cells in vitro. The rate of PSA secretion (normalized per equal cell number) by control and drug treated cells was similar, as determined by a solid phase, two-site immunoradiometric assay. Consistent with the lack of effect of irofulven on PSA protein level, the drug does not appear to affect the expression of PSA mRNA (on a per cell basis) as assessed by RT-PCR. Thus, changes in PSA secretion and expression appear to reflect irofulven-induced cell growth inhibition rather than reflecting a direct effect of the drug on PSA. These results suggest that PSA should be a reasonable marker of tumor burden in irofulven-treated prostate cancer patients.

  11. Treatment for A2-B2 prostatic carcinoma: results of hormone-radiotherapy combination in PSA era; Traitement des cancers prostatiques A2-B2: resultats d`une association hormonoradiotherapique dans l`ere du PSA

    Energy Technology Data Exchange (ETDEWEB)

    Salem, N.; Richaud, P.; Gaston, R.; Chacon, B.; Mauriac, L.; Bussieres, E. [Institut Bergonie, Centre Regional de Lutte Contre le Cancer, 33 - Bordeaux (France)

    1998-05-01

    Prospective analysis of results of combined neo-adjuvant hormonotherapy and external beam radiation therapy in A2-B2 prostate adenocarcinoma. Between 1986 and 1994, 36 patients with clinical stage A2 (five patients), B1 (12 patients) and B2 (19 patients) N0 adenocarcinoma of the prostate declined for radical surgery, underwent a brief neo-adjuvant hormonal therapy before external beam radiotherapy at our radiation therapy department. They all had a PSA determination before the combined treatment and no evidence of local extension or metastatic spread. They were followed clinically and with serial PSA levels for a median time of 58 months. Relapse was defined by a PSA level {>=}2.5 ng/mL. Median pre-treatment PSA level was 16.5 ng/mL; 16 patients had less than 15 ng/mL. Combined treatment was very well tolerated. After 3 months of neo-adjuvant hormonotherapy, digital rectal examination was normalized in 27 cases with a PSA value {<=} 1 ng/mL in 23. Only four tumors have relapsed (one local failure, two metastases and one PSA failure). The single factor that predicted biochemical relapse was pre-treatment PSA level: the 5-year actuarial rate of PSA failure when PSA level < 15 ng/ml was 0% and 27.5% if it was {>=} 15 ng/mL (p = 0.05). During follow- up only two patients suffered grade 2 rectitis and seven complained a total impotency. This limited study advocates hormonal neo-adjuvant therapy and radiotherapy association in intra-capsular prostatic carcinoma in patients declined for surgery or when pre-treatment PSA is above 15 ng/mL, with mild acute and late toxicity. (authors)

  12. Screening uptake rates and the clinical and cost effectiveness of screening for gestational diabetes mellitus in primary versus secondary care: study protocol for a randomised controlled trial.

    LENUS (Irish Health Repository)

    O Dea, Angela

    2014-01-17

    The risks associated with gestational diabetes mellitus (GDM) are well recognized, and there is increasing evidence to support treatment of the condition. However, clear guidance on the ideal approach to screening for GDM is lacking. Professional groups continue to debate whether selective screening (based on risk factors) or universal screening is the most appropriate approach. Additionally, there is ongoing debate about what levels of glucose abnormalities during pregnancy respond best to treatment and which maternal and neonatal outcomes benefit most from treatment. Furthermore, the implications of possible screening options on health care costs are not well established. In response to this uncertainty there have been repeated calls for well-designed, randomised trials to determine the efficacy of screening, diagnosis, and management plans for GDM. We describe a randomised controlled trial to investigate screening uptake rates and the clinical and cost effectiveness of screening in primary versus secondary care settings. The objective of this study is to assess screening uptake rates, and the clinical and cost effectiveness of screening for GDM in primary versus secondary care.

  13. Prostate-specific antigen screening and prostate cancer treatment in renal transplantation candidates: A survey of U.S. transplantation centers.

    Science.gov (United States)

    Gin, Greg E; Pereira, Jorge F; Weinberg, Alan D; Mehrazin, Reza; Lerner, Susan M; Sfakianos, John P; Phillips, Courtney K

    2016-02-01

    Renal transplantation candidates are a highly screened population. There are currently no guidelines or consensus on prostate cancer (CaP) screening in these patients. In light of the recent United States Preventive Services Task Force recommendations against prostate-specific antigen (PSA) screening, we conducted a survey of transplantation surgeons to gain a better understanding of practice patterns among U.S. centers. A 14-question multiple-choice online survey was e-mailed to 195 U.S. renal transplantation centers. The questionnaire assessed CaP screening and treatment practices. The survey also evaluated characteristics of the respondent's institution. Descriptive statistics were used for each of the responses, and associations were made with program characterization using logistic or linear regression models. A total of 90 surgeons responded, representing 65 of 195 programs (33% response rate). Overall, 89% of respondents reported routinely screening for CaP in renal transplantation candidates and 71% had set guidelines for PSA screening. The most common age to start PSA screening was 50 years (51%) and 79% of respondents reported no age limit to stop PSA screening. Definitive treatment of CaP was required before proceeding to transplantation in 45% of respondents. Active surveillance was a viable option in 67% of responders. Most respondents (73%) replied that the waiting time for eligibility after treatment depended on the CaP stage and risk. Although most programs have guidelines on PSA screening in renal transplantation candidates, there is still variation nationwide in screening and treatment practices. AS is a viable treatment option in most of the programs. Our results suggest a benefit of a consensus panel to recommend guidelines in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Increased PSA expression on prostate cancer exosomes in in vitro condition and in cancer patients.

    Science.gov (United States)

    Logozzi, Mariantonia; Angelini, Daniela F; Iessi, Elisabetta; Mizzoni, Davide; Di Raimo, Rossella; Federici, Cristina; Lugini, Luana; Borsellino, Giovanna; Gentilucci, Alessandro; Pierella, Federico; Marzio, Vittorio; Sciarra, Alessandro; Battistini, Luca; Fais, Stefano

    2017-09-10

    exosomes, such as PSA-exosomes, may represent a novel, non-invasive clinical tool for the screening and early diagnosis of prostate cancer. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Combination of Autoantibody Signature with PSA Level Enables a Highly Accurate Blood-Based Differentiation of Prostate Cancer Patients from Patients with Benign Prostatic Hyperplasia.

    Science.gov (United States)

    Leidinger, Petra; Keller, Andreas; Milchram, Lisa; Harz, Christian; Hart, Martin; Werth, Angelika; Lenhof, Hans-Peter; Weinhäusel, Andreas; Keck, Bastian; Wullich, Bernd; Ludwig, Nicole; Meese, Eckart

    2015-01-01

    Although an increased level of the prostate-specific antigen can be an indication for prostate cancer, other reasons often lead to a high rate of false positive results. Therefore, an additional serological screening of autoantibodies in patients' sera could improve the detection of prostate cancer. We performed protein macroarray screening with sera from 49 prostate cancer patients, 70 patients with benign prostatic hyperplasia and 28 healthy controls and compared the autoimmune response in those groups. We were able to distinguish prostate cancer patients from normal controls with an accuracy of 83.2%, patients with benign prostatic hyperplasia from normal controls with an accuracy of 86.0% and prostate cancer patients from patients with benign prostatic hyperplasia with an accuracy of 70.3%. Combining seroreactivity pattern with a PSA level of higher than 4.0 ng/ml this classification could be improved to an accuracy of 84.1%. For selected proteins we were able to confirm the differential expression by using luminex on 84 samples. We provide a minimally invasive serological method to reduce false positive results in detection of prostate cancer and according to PSA screening to distinguish men with prostate cancer from men with benign prostatic hyperplasia.

  16. Combination of Autoantibody Signature with PSA Level Enables a Highly Accurate Blood-Based Differentiation of Prostate Cancer Patients from Patients with Benign Prostatic Hyperplasia.

    Directory of Open Access Journals (Sweden)

    Petra Leidinger

    Full Text Available Although an increased level of the prostate-specific antigen can be an indication for prostate cancer, other reasons often lead to a high rate of false positive results. Therefore, an additional serological screening of autoantibodies in patients' sera could improve the detection of prostate cancer. We performed protein macroarray screening with sera from 49 prostate cancer patients, 70 patients with benign prostatic hyperplasia and 28 healthy controls and compared the autoimmune response in those groups. We were able to distinguish prostate cancer patients from normal controls with an accuracy of 83.2%, patients with benign prostatic hyperplasia from normal controls with an accuracy of 86.0% and prostate cancer patients from patients with benign prostatic hyperplasia with an accuracy of 70.3%. Combining seroreactivity pattern with a PSA level of higher than 4.0 ng/ml this classification could be improved to an accuracy of 84.1%. For selected proteins we were able to confirm the differential expression by using luminex on 84 samples. We provide a minimally invasive serological method to reduce false positive results in detection of prostate cancer and according to PSA screening to distinguish men with prostate cancer from men with benign prostatic hyperplasia.

  17. Prostate Cancer Screening: the role of biopsy, PSA, PSA dynamics and isoforms

    NARCIS (Netherlands)

    P.F.J. Raaijmakers (René)

    2009-01-01

    textabstractIn the beginning of the past century, A. Astraldi urologist from Buenos Aires, Argentina, recognized the importance of early detection of prostate cancer and was unsatisfied with the available diagnostic tools he had to his disposal. The only diagnostic means for the urologist at that

  18. Simple Risk Stratification to Detect Prostate Cancer with High Gleason Score in Repeat Biopsies in a Population Screening Follow-up Study.

    Science.gov (United States)

    Kitagawa, Yasuhide; Urata, Satoko; Mizokami, Atsushi; Nakashima, Kazuyoshi; Koshida, Kiyoshi; Nakashima, Takao; Miyazaki, Kimiomi; Namiki, Mikio

    2015-09-01

    To investigate the clinical usefulness of percentage free prostate-specific antigen (%fPSA) and PSA velocity (PSAV) for detecting prostate cancer in repeat biopsies in a population-based screening cohort. In total, 178 men with serum PSA levels within 2.1-10 ng/ml who underwent repeat biopsies after initial negative biopsy results, were enrolled. Prostate cancer detection rates with a Gleason score of 7 or more according to age, serum PSA, %fPSA, and PSAV were investigated. The cumulative probability of detecting cancer according to risk factors was also investigated. Out of 178 men who underwent repeat biopsy, 48 (27.0%) were diagnosed with prostate cancer during the observation period, and pathological examination revealed prostate cancer with a Gleason score of 7 or more in 17 patients (35.4%). In the multivariate logistic regression analysis, %fPSA ≤ 12 at repeat biopsy and PSAV >0.40 ng/ml/year were determined to be independent risk factors for prostate cancer, and %fPSA ≤ 12 at initial biopsy and PSAV >0.40 for cancer of Gleason score 7 or greater. The cumulative probabilities of developing high-grade cancer after 5 years were 55.8% and 4.0% in men with %fPSA ≤ 12 at initial biopsy and PSAV >0.40, and in men without both, respectively. There was a statistically significant difference in probabilities between groups by the log-rank test. The present results demonstrated that %fPSA and PSAV were predictors of prostate cancer with a Gleason score of 7 or more in repeat biopsy after a negative initial biopsy on a population follow-up basis. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  19. 40 CFR Appendix III to Part 266 - Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride III Appendix III to Part 266 Protection of Environment... to Part 266—Tier II Emission Rate Screening Limits for Free Chlorine and Hydrogen Chloride Terrain...

  20. Has Province-Wide Symptom Screening Changed Opioid Prescribing Rates in Older Patients With Cancer?

    Science.gov (United States)

    Barbera, Lisa; Sutradhar, Rinku; Chu, Anna; Seow, Hsien; Earle, Craig C; O'Brien, Mary Ann; Dudgeon, Deborah; DeAngelis, Carlo; Atzema, Clare; Husain, Amna; Liu, Ying; Howell, Doris

    2017-11-01

    Previous work in Ontario demonstrated that 33% of patients with cancer with severe pain did not receive opioids at the time of their pain assessment. With efforts to increase symptom screening and management since then, the objective of this study was to examine temporal trends in opioid prescribing. The cohort was comprised of Ontario residents ≥ 65 years of age with a cancer history who were eligible for the government pharmacare program and had a pain assessment using the Edmonton Symptom Assessment System. Use of the Edmonton Symptom Assessment System is part of a provincial initiative to screen ambulatory patients with cancer for symptoms. Annually between 2007 and 2013, we used the date of an individual's highest pain score as the index date to calculate annual opioid prescription rates for claims within 30 days before and up to 7 days after the index date. A logistic regression model evaluated the association between index year and odds of receiving an opioid prescription. During the study period, the number of individuals undergoing symptom assessment annually increased more than eight-fold. Opioid prescription rates were directly related to pain scores, but there was an annual 5% relative decrease in the odds of receiving an opioid prescription during the era from 2009 to 2013. We are doing better at screening for pain, but this has not led to an increase in analgesic intervention for those identified. Additional work is required to determine what opioid prescribing rate is optimal to ensure we are not missing opportunities to improve patient comfort.

  1. Seminal plasma PSA in spinal cord injured men

    DEFF Research Database (Denmark)

    Brasso, K; Sønksen, J; Sommer, P

    1998-01-01

    The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration.......The aim of the study was to evaluate the impact of spinal cord injury on seminal plasma PSA concentration....

  2. STD Awareness PSA - College 2 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA, targeted to college-aged youth and young adults, encourages listeners to get tested for STDs.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  3. STD Awareness PSA - College 1 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA, targeted to college-aged youth and young adults, encourages listeners to get tested for STDs.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  4. STD Awareness PSA - Male Announcer 2 (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-22

    This PSA encourages listeners to get tested for STDs. Target - Men who have sex with other men.  Created: 4/22/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/22/2010.

  5. Secundaire analyses organisatiebeleid psychosociale arbeidsbelasting (PSA)

    NARCIS (Netherlands)

    Kraan, K.O.; Houtman, I.L.D.

    2016-01-01

    Hoe het organisatiebeleid rond psychosociale arbeidsbelasting (PSA) eruit ziet anno 2014 en welke samenhang er is met ander beleid en uitkomstmaten, zijn de centrale vragen in dit onderzoek. De resultaten van deze verdiepende analyses kunnen ten goede komen aan de lopende campagne ‘Check je

  6. Interoperability in the Planetary Science Archive (PSA)

    Science.gov (United States)

    Rios Diaz, C.

    2017-09-01

    The protocols and standards currently being supported by the recently released new version of the Planetary Science Archive at this time are the Planetary Data Access Protocol (PDAP), the EuroPlanet- Table Access Protocol (EPN-TAP) and Open Geospatial Consortium (OGC) standards. We explore these protocols in more detail providing scientifically useful examples of their usage within the PSA.

  7. High prevalence of psoriatic arthritis in patients with severe psoriasis with suboptimal performance of screening questionnaires.

    LENUS (Irish Health Repository)

    Haroon, Muhammad

    2013-05-01

    The objectives of this study were to: (1) assess the prevalence of psoriatic arthritis (PsA) among Psoriasis (Ps) patients attending dermatology clinics; (2) identify clinical predictors of the development of PsA; and (3) compare the performance of three PsA screening questionnaires: Psoriatic Arthritis Screening and Evaluation (PASE), Psoriasis Epidemiology Screening Tool (PEST) and Toronto Psoriatic Arthritis Screening (ToPAS).

  8. PSA testing anxiety, psychological morbidity, and PSA utility in the management of prostate cancer.

    OpenAIRE

    Micsunescu, Anamaria Elia

    2017-01-01

    Anecdotal reports from urologists and medical oncologists have suggested that patients with prostate cancer (PCa) often present with anxiety related to ongoing monitoring of their PSA levels as part of their disease management. The purpose of the current study, therefore, was to determine the prevalence and severity of prostate specific antigen (PSA) testing anxiety in a population of patients with either localised or metastatic PCa living in Australia. Other aspects of psychological morbidit...

  9. Low rates of cervical cancer screening among urban immigrants: a population-based study in Ontario, Canada.

    Science.gov (United States)

    Lofters, Aisha K; Moineddin, Rahim; Hwang, Stephen W; Glazier, Richard H

    2010-07-01

    Women who are immigrants or socioeconomically disadvantaged have been found to have significantly lower cervical cancer screening rates than their peers in Toronto, Ontario, Canada. The objective of this study was to examine rates of appropriate cervical cancer screening among women living in Ontario, Canada, using recent registration with Ontario's universal health insurance plan as an indicator of immigrant status. This retrospective cohort study included 2,273,995 screening-eligible women aged 25 to 69 years, who resided in Ontario's metropolitan areas during the calendar years 2003, 2004, and 2005. A validated algorithm was applied to the Ontario-wide physicians' claims database to determine which women had undergone cervical cancer screening with a Pap test during the 3-year period. Appropriate cervical cancer screening occurred for 61.1% of women. Despite adjustment for physician contact and pregnancy rates, cervical cancer screening rates were especially low among: women aged 50 to 69 years; women living in low-income areas; and women who had registered with Ontario's universal health insurance plan within the preceding 10 years, a group consisting largely of recent immigrants. Women with all 3 of these characteristics had a screening rate of 31.0% compared with 70.5% among women with none of these characteristics. Within a system of universal health insurance, appropriate cervical cancer screening is significantly lower among women who are older, living in low-income areas, or recent immigrants. Efforts to reduce disparities in cervical cancer screening should focus on women with these characteristics.

  10. Effectiveness of interventions to increase the participation rate of gastric cancer screening in the Republic of Korea: a pilot study.

    Science.gov (United States)

    Lee, Myung Ha; Lee, Yoon Young; Jung, Da Won; Park, Boyoung; Yun, E Hwa; Lee, Hoo-Yeon; Jun, Jae Kwan; Choi, Kui Son

    2012-01-01

    This study assessed the effectiveness of three intervention strategies to improve the participation rate of gastric cancer screening among people who had never undergone such screening, and those who had been screened for the disease, but not recently. It was conducted in the Ilsandong-gu District of Goyang City, Korea. The population for the current study was restricted to male residents, aged 40-65 years, who received an invitation letter to undergo gastric cancer screening from the National Health Insurance (NHI) Corporation at the beginning of 2010. The subjects were divided into two categories according to their screening history: never-screened, and ever-screened. A total of 2,065 men were eligible: 803 never-screened and 1,262 ever-screened. In each screening category they were randomly assigned to one of three intervention groups: 1) tailored telephone counseling; 2) tailored postcard reminder after tailored telephone counseling;and 3) tailored telephone counseling after tailored postcard reminder. At 3 months post-intervention, never- screened men with any intervention were more likely to undergo gastric cancer screening (OR=2.75, 95% CI: 1.22-6.18) compared to those in the reference group (no intervention). However, there was no statistically significant intervention effect in ever-screened men (OR=1.21, 95% CI: 0.65-2.27). Examination of the intervention effects by intervention group among never-screened men showed that those in the postcard reminder after telephone counseling group to be statistically significantly more likely to undergo gastric cancer screening (OR=4.49, 95% CI: 1.79-11.29) than the reference group (no intervention). Our results highlight that use of tailored postcard reminders after tailored telephone counseling is an effective method to increase participation in gastric cancer screening among men who had never been screened.

  11. Change in PSA velocity is a predictor of overall survival in men with biochemically-recurrent prostate cancer treated with nonhormonal agents: combined analysis of four phase-2 trials.

    Science.gov (United States)

    Suzman, D L; Zhou, X C; Zahurak, M L; Lin, J; Antonarakis, E S

    2015-03-01

    Multiple phase-2 trials in men with biochemically-recurrent prostate cancer (BRPC) have assessed the impact of nonhormonal agents on PSA kinetics. We have previously demonstrated that changes in PSA kinetics correlate with metastasis-free survival; however, it is unknown whether these changes also correlate with overall survival (OS). We performed a combined retrospective analysis of 146 men with BRPC treated on phase-2 trials using one of four investigational drugs: lenalidomide (n=60), marimastat (n=39), ATN-224 (n=22) and imatinib (n=25). We examined factors influencing OS, including within-subject changes in PSA kinetics (PSA slope, PSA doubling time and PSA velocity), before and 6 months after treatment initiation. After a median follow-up of 83.1 months, 49 of 146 men had died. In univariate Cox regression analysis, two factors were associated with OS: baseline PSA velocity and change in PSA velocity on therapy. In a landmark multivariable model, stratified by study (which controlled for age, Gleason score, type of local therapy and use of androgen-deprivation therapy prior to metastases), baseline PSA velocity and increase in PSA velocity on therapy remained independent predictors of OS. Median OS for men with an increase in PSA velocity on treatment was 115.4 months and was not reached for men with a decrease in PSA velocity (hazard ratio=0.47, 95% confidence interval 0.25-0.88; P=0.02). This hypothesis-generating study suggests that within-subject changes in PSA velocity after initiation of nonhormonal therapy may correlate with OS in men with BRPC. If validated in prospective trials, change in PSA velocity may represent a reasonable intermediate end point for screening new agents in these patients.

  12. 40 CFR Appendix I to Part 266 - Tier I and Tier II Feed Rate and Emissions Screening Limits for Metals

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Tier I and Tier II Feed Rate and...—Tier I and Tier II Feed Rate and Emissions Screening Limits for Metals Table I-A—Tier I and Tier II...+06 1.8E+03 6.0E+03 6.0E+04 6.0E+03 Table I-B—Tier i and Tier II Feed Rate and Emissions Screening...

  13. Block Recovery Rate-Based Unequal Error Protection for Three-Screen TV

    Directory of Open Access Journals (Sweden)

    Hojin Ha

    2017-02-01

    Full Text Available This paper describes a three-screen television system using a block recovery rate (BRR-based unequal error protection (UEP. The proposed in-home wireless network uses scalable video coding (SVC and UEP with forward error correction (FEC for maximizing the quality of service (QoS over error-prone wireless networks. For efficient FEC packet assignment, this paper proposes a simple and efficient performance metric, a BRR which is defined as a recovery rate of temporal and quality layer from FEC assignment by analyzing the hierarchical prediction structure including the current packet loss. It also explains the SVC layer switching scheme according to network conditions such as packet loss rate (PLR and available bandwidth (ABW. In the experiments conducted, gains in video quality with the proposed UEP scheme vary from 1 to 3 dB in Y-peak signal-to-noise ratio (PSNR with corresponding subjective video quality improvements.

  14. Trends in Cancer Screening Rates among Korean Men and Women: Results from the Korean National Cancer Screening Survey (KNCSS), 2004-2010

    OpenAIRE

    Lee, Eun-Ha; Lee, Hoo-Yeon; Choi, Kui Son; Jun, Jae Kwan; Park, Eun-Cheol; Lee, Jin Soo

    2011-01-01

    Purpose The Korean National Cancer Screening Survey (KNCSS) is a continuous nationwide survey implemented by the National Cancer Center in Korea since 2004. The purpose of the present study was to report trends in cancer screening rates for the five major cancers (stomach, liver, colorectal, breast, and cervix uteri) in Korean men and women. Materials and Methods The study used KNCSS data collected between 2004 and 2010. The survey was conducted on Korean men aged 40-74 years and Korean women...

  15. Investigating the prostate specific antigen, body mass index and age relationship: is an age-BMI-adjusted PSA model clinically useful?

    Science.gov (United States)

    Harrison, Sean; Tilling, Kate; Turner, Emma L; Lane, J Athene; Simpkin, Andrew; Davis, Michael; Donovan, Jenny; Hamdy, Freddie C; Neal, David E; Martin, Richard M

    2016-12-01

    Previous studies indicate a possible inverse relationship between prostate-specific antigen (PSA) and body mass index (BMI), and a positive relationship between PSA and age. We investigated the associations between age, BMI, PSA, and screen-detected prostate cancer to determine whether an age-BMI-adjusted PSA model would be clinically useful for detecting prostate cancer. Cross-sectional analysis nested within the UK ProtecT trial of treatments for localized cancer. Of 18,238 men aged 50-69 years, 9,457 men without screen-detected prostate cancer (controls) and 1,836 men with prostate cancer (cases) met inclusion criteria: no history of prostate cancer or diabetes; PSA BMI between 15 and 50 kg/m(2). Multivariable linear regression models were used to investigate the relationship between log-PSA, age, and BMI in all men, controlling for prostate cancer status. In the 11,293 included men, the median PSA was 1.2 ng/ml (IQR: 0.7-2.6); mean age 61.7 years (SD 4.9); and mean BMI 26.8 kg/m(2) (SD 3.7). There were a 5.1% decrease in PSA per 5 kg/m(2) increase in BMI (95% CI 3.4-6.8) and a 13.6% increase in PSA per 5-year increase in age (95% CI 12.0-15.1). Interaction tests showed no evidence for different associations between age, BMI, and PSA in men above and below 3.0 ng/ml (all p for interaction >0.2). The age-BMI-adjusted PSA model performed as well as an age-adjusted model based on National Institute for Health and Care Excellence (NICE) guidelines at detecting prostate cancer. Age and BMI were associated with small changes in PSA. An age-BMI-adjusted PSA model is no more clinically useful for detecting prostate cancer than current NICE guidelines. Future studies looking at the effect of different variables on PSA, independent of their effect on prostate cancer, may improve the discrimination of PSA for prostate cancer.

  16. Extent of disease in recurrent prostate cancer determined by [{sup 68}Ga]PSMA-HBED-CC PET/CT in relation to PSA levels, PSA doubling time and Gleason score

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, Frederik A.; Mottaghy, Felix M. [RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands); Pfister, David; Heidenreich, Axel [RWTH University Hospital Aachen, Department of Urology, Aachen (Germany); Vogg, Andreas; Drude, Natascha I.; Behrendt, Florian F. [RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany); Voeoe, Stefan [Maastricht University Medical Center, Department of Nuclear Medicine, Maastricht (Netherlands)

    2016-03-15

    To examine the relationship between the extent of disease determined by [{sup 68}Ga]PSMA-HBED-CC-PET/CT and the important clinical measures prostate-specific antigen (PSA), PSA doubling time (PSAdt) and Gleason score. We retrospectively studied the first 155 patients with recurrent prostate cancer (PCA) referred to our university hospital for [{sup 68}Ga]PSMA-HBED-CC PET/CT. PET/CT was positive in 44 %, 79 % and 89 % of patients with PSA levels of ≤1, 1 - 2 and ≥2 ng/ml, respectively. Patients with high PSA levels showed higher rates of local prostate tumours (p < 0.001), and extrapelvic lymph node (p = 0.037) and bone metastases (p = 0.013). A shorter PSAdt was significantly associated with pelvic lymph node (p = 0.026), extrapelvic lymph node (p = 0.001), bone (p < 0.001) and visceral (p = 0.041) metastases. A high Gleason score was associated with more frequent pelvic lymph node metastases (p = 0.039). In multivariate analysis, both PSA and PSAdt were independent determinants of scan positivity and of extrapelvic lymph node metastases. PSAdt was the only independent marker of bone metastases (p = 0.001). Of 20 patients with a PSAdt <6 months and a PSA ≥2 ng/ml, 19 (95 %) had a positive scan and 12 (60 %) had M1a disease. Of 14 patients with PSA <1 ng/ml and PSAdt >6 months, only 5 (36 %) had a positive scan and 1 (7 %) had M1a disease. [{sup 68}Ga]PSMA-HBED-CC PET/CT will identify PCA lesions even in patients with very low PSA levels. Higher PSA levels and shorter PSAdt are independently associated with scan positivity and extrapelvic metastases, and can be used for patient selection for [{sup 68}Ga]PSMA-HBED-CC PET/CT. (orig.)

  17. Parent-rated measures of bilingual children's speech accuracy: Implications for a universal speech screen.

    Science.gov (United States)

    Kim, Jae-Hyun; Ballard, Elaine; McCann, Clare M

    2016-04-01

    This study investigated whether parents were reliable in judging their bilingual children's speech and whether parent-rated measure of children's speech could be used as a tool for a universal speech screen to identify children with speech sound disorder (SSD). Single word samples from 33 Korean-English bilingual (KEB) pre-school children were analysed for percentage of consonants correct (PCC). Their parents completed the Intelligibility in Context Scale and a similarly constructed scale devised by Stertzbach and Gildersleeve-Neumann. Spearman rank correlations were used to examine the association between the PCC scores and the parent-rated measures. A number of factors influenced parents' reliability in judging their bilingual children's speech, including language dominance and the nature of the questions that were asked. The perception of strangers on a child's speech problems, as judged by the parents, could be significant in identifying children with SSD. When the cut-off ICS mean score derived from a previous monolingual research was applied to KEB children, over 40% of the sample was identified as requiring a comprehensive clinical assessment. Implementation of a universal speech screen utilising parent-rated measures of children's speech cannot be introduced without further research.

  18. Tuberculosis progression rates in U.S. Immigrants following screening with interferon-gamma release assays

    Directory of Open Access Journals (Sweden)

    Robert J. Blount

    2016-08-01

    Full Text Available Abstract Background Interferon-gamma release assays may be used as an alternative to the tuberculin skin test for detection of M. tuberculosis infection. However, the risk of active tuberculosis disease following screening using interferon-gamma release assays in immigrants is not well defined. To address these uncertainties, we determined the incidence rates of active tuberculosis disease in a cohort of high-risk immigrants with Class B TB screened with interferon-gamma release assays (IGRAs upon arrival in the United States. Methods Using a retrospective cohort design, we enrolled recent U.S. immigrants with Class B TB who were screened with an IGRA (QuantiFERON ® Gold or Gold In-Tube Assay at the San Francisco Department of Public Health Tuberculosis Control Clinic from January 2005 through December 2010. We reviewed records from the Tuberculosis Control Patient Management Database and from the California Department of Public Health Tuberculosis Case Registry to determine incident cases of active tuberculosis disease through February 2015. Results Of 1233 eligible immigrants with IGRA screening at baseline, 81 (6.6 % were diagnosed with active tuberculosis disease as a result of their initial evaluation. Of the remaining 1152 participants without active tuberculosis disease at baseline, 513 tested IGRA-positive and 639 tested IGRA-negative. Seven participants developed incident active tuberculosis disease over 7730 person-years of follow-up, for an incidence rate of 91 per 100,000 person-years (95 % CI 43–190. Five IGRA-positive and two IGRA-negative participants developed active tuberculosis disease (incidence rates 139 per 100,000 person-years (95 % CI 58–335 and 48 per 100,000 person-years (95 % CI 12–193, respectively for an unadjusted incidence rate ratio of 2.9 (95 % CI 0.5–30, p = 0.21. IGRA test results had a negative predictive value of 99.7 % but a positive predictive value of only 0.97 %. Conclusions Among high

  19. Effect of population screening for type 2 diabetes and cardiovascular risk factors on mortality rate and cardiovascular events

    DEFF Research Database (Denmark)

    Simmons, Rebecca K; Griffin, Simon J; Witte, Daniel R

    2017-01-01

    -based screening for type 2 diabetes and cardiovascular risk factors on mortality rates and cardiovascular events. METHODS: This register-based, non-randomised, controlled trial included men and women aged 40-69 years without known diabetes who were registered with a general practice in Denmark (n = 1......-screening group (HR 0.99 [0.96, 1.02], p = 0.49). CONCLUSIONS/INTERPRETATION: A population-based stepwise screening programme for type 2 diabetes and cardiovascular risk factors among all middle-aged adults in Denmark was not associated with a reduction in rate of mortality or cardiovascular events between 2001...... were invited to visit their GP for assessment of diabetes status and cardiovascular risk (screening group). The 1,759,285 individuals registered with all other general practices in Denmark constituted the retrospectively constructed no-screening (control) group. Outcomes were mortality rate...

  20. Effectiveness diagnostic of prostate specific antigen (P.S.A.) radioimmunoassay and the P.S.A. density to assess prostatic state of Ivorian patients; Efficacite diagnostique du dosage radio-isotopique et de la densite de l'antigene specifique de la prostate (P.S.A.) dans le bilan prostatique des sujets ivoiriens

    Energy Technology Data Exchange (ETDEWEB)

    Aboukoua-Kouassi, N.; Kouame-Koutouan, A.; Zunon-Kipre, E.; Achy, O.B.; Ndrin, N.K. [Cocody Univ., UFR sciences Medicales (SMA), Service de Biophysique et Medecine Nucleaire, Abidjan (Cote d' Ivoire); Achy, O.B.; Gnagne, Y.M. [Cocody Univ., Service d' Urologie, UFR/SMA, Abidjan (Cote d' Ivoire)

    2009-10-15

    By this first assay realized during two years, the authors wanted to assess the diagnostic performances of radioimmunoassay P.S.A., still unknown by Ivorian prescribers. It was about 78 patients who presented prostatic affections confirmed by histology. The dosages showed that, in prostate adenoma, a P.S.A. level was 9.5 ng/ml with P.S.A. density (P.S.A.D.) at 0.3. In prostate cancer, a P.S.A. level at 64.9 ng/ml with P.S.A.D. at 1.68. P.S.A. sensibility was good (91%) in spite of the value used, its specificity was about 94% for a level of 20 ng/ml. The predictive positive value was excellent with 20 ng/ml (95%). The risk to have prostate cancer with P.S.A. level of 10 ng/ml was 73.8% when rectal route (R.R.) was abnormal. The risk was low to 14.28% when the R.R. was normal. The radioimmunoassay of P.S.A. and P.S.A.D. rate improved significantly diagnostic indications in prostatic affections. Consequently, it must form part of first-line examination to the health assessment of old patients for a better prostatic lesions management. (authors)

  1. Take Charge. Take the Test. PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2012-03-07

    As part of the Take Charge. Take the Test. campaign, this 30 second PSA encourages African American women to get tested for HIV. Locations for a free HIV test can be found by visiting hivtest.org/takecharge or calling 1-800-CDC-INFO (1-800-232-4636).  Created: 3/7/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/7/2012.

  2. More Adults Are Walking PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-07-31

    This 60 second PSA is based on the August 2012 CDC Vital Signs report. While more adults are walking, only half get the recommended amount of physical activity. Listen to learn how communities, employers, and individuals may help increase walking.  Created: 7/31/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/7/2012.

  3. Safer Food Saves Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-11-03

    This 60 second PSA is based on the November 2015 CDC Vital Signs report. Contaminated food sent to several states can cause multistate outbreaks of foodborne illness and make a lot of people seriously ill. Learn what can be done to prevent and stop outbreaks.  Created: 11/3/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 11/3/2015.

  4. Stop C. difficile Infections PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-03-06

    This 60 second PSA is based on the March 2012 CDC Vital Signs report. C. difficile is a germ that causes diarrhea linked to 14,000 deaths in the US each year. This podcast helps health care professionals learn how to prevent C. difficile infections.  Created: 3/6/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/6/2012.

  5. Communication Can Save Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-08-04

    This 60 second public service announcement (PSA) is based on the August 2015 CDC Vital Signs report. Antibiotic-resistant germs cause at least 23,000 deaths each year. Learn how public health authorities and health care facilities can work together to save lives.  Created: 8/4/2015 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 8/4/2015.

  6. Experience from the comparison of two PSA-studies

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, J.; Pulkkinen, U. [VTTAutomation (Finland)

    2001-03-01

    Two probabilistic safety assessments (PSA) made for nearly identical reactors units (Forsmark 3 and Oskarshamn 3) have been compared. Two different analysis teams made the PSAs, and the analyses became quite different. The goal of the study is to identify, clarify and explain differences between PSA-studies. The purpose is to understand limitations and uncertainties in PSA, to explain reasons for differences between PSA-studies, and to give recommendations for comparison of PSA-studies and for improving the PSA-methodology. The reviews have been made by reading PSA-documentation, using the computer model and interviewing persons involved in the projects. The method and findings have been discussed within the project group. Both the PSA-project and various parts in the PSA-model have been reviewed. A major finding was that the two projects had different purpose and thus had different resources, scope and even methods in their study. The study shows that comparison of PSA results from different plants is normally not meaningful. It takes a very deep knowledge of the PSA studies to make a comparison of the results and usually one has to ensure that the compared studies have the same scope and are based on the same analysis methods. Harmonisation of the PSA-methodology is recommended in the presentation of results, presentation of methods, scope main limitation and assumption, and definitions for end states, initiating events and common cause failures. This would facilitate the comparison of the studies. Methods for validation of PSA for different application areas should be developed. The developed PSA review standards can be applied for a general validation of a study. The most important way to evaluate the real feasibility of PSA can take place only with practical applications. The PSA-documentation and models can be developed to facilitate the communication between PSA-experts and users. In any application consultation with the PSA-expert is however needed. Many

  7. The cutoff level of free/total prostate specific antigen (f/t PSA ratios in the diagnosis of prostate cancer: A validation study on a Turkish patient population in different age categories

    Directory of Open Access Journals (Sweden)

    Bulent Erol

    2014-11-01

    Full Text Available We investigated an optimal cutoff level of free/total PSA ratios (f/t PSA in predicting prostate cancer in different age groups, focusing on the avoidance of unnecessary prostate biopsies. A total of 4955 men were enrolled into the study. Serum tPSA, fPSA, and f/t PSA ratios were determined for the study population. All males who had suspicious digital rectal examination and tPSA > 4 ng/mL underwent transrectal ultrasonography-guided prostate biopsy. Receiver operating characteristic (ROC curves for each group were generated by plotting the sensitivity versus 1-specificity for the f/t PSA ratio. The sensitivity, specificity, positive likelihood ratio (PLR, and negative likelihood ratio (NLR were obtained using various f/t PSA ratio cutoffs for different age groups. There were 657 patients with a PSA level of 4–10 ng/mL. According to sensitivity and specificity f/t% PSA cutoff points were determined to be 10%, 15%, 15%, and 10% in 50–59 years, 60–69 years, >70 years, and all ages categories, respectively, in patients with initial PSA level of 4–10 ng/mL. f/t PSA ratio had an area under the curve (AUC value of 0.81 (95% confidence level: 0.80–0.82 for all age groups in detecting prostate cancer. f/t PSA ratio has an AUC value of 0.669 (0.632–0.705 in detecting prostate cancer among patients with a PSA level of 4–10 ng/mL. Ten percent of f/t PSA ratio had the highest specificity with PLR and 30% f/t PSA ratio had the highest sensitivity with lower NLR in the all-age categories. The current study shows that the use of f/t PSA ratio in patients with PSA levels of 4–10 ng/mL should enhance the specificity of PSA screening and decrease the number of unnecessary biopsies. The age-related changes warrant further investigation in a large, multicentric, and multinational population to improve the clinical use of f/t PSA cutoffs.

  8. Review article: Prostate cancer screening using prostate specific ...

    African Journals Online (AJOL)

    Background: Prostate cancer is the commonest cancer among men in Nigeria and early detection is key to cure and survival but its screening through prostate specific antigen (PSA) has remain controversial in literature. Screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than ...

  9. Prostate cancer awareness and screening among male public ...

    African Journals Online (AJOL)

    Conclusion: Despite a high awareness of PCa among public servants in Anambra State, Nigeria, a very small proportion of these men had undergone PSA screening. To achieve a stage migration in PCa detection in Nigeria, early detection using PSA screening should be actively driven by health personnel using the media ...

  10. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis

    NARCIS (Netherlands)

    S. Carlsson (Sigrid); T.M. de Carvalho Delgado Marques (Tiago); M.J. Roobol-Bouts (Monique); J. Hugosson (Jonas); A. Auvinen (Anssi); M. Kwiatkowski (Maciej); A. Villers (Arnoud); M. Zappa (Marco); V. Nelen (Vera); A. Páez (Alvaro); J.A. Eastham (James); H. Lilja (Hans); H.J. de Koning (Harry); A.J. Vickers (Andrew); E.A.M. Heijnsdijk (Eveline)

    2016-01-01

    textabstractBACKGROUND: Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus “good practice.”. METHODS: Microsimulation screening analysis (MISCAN)

  11. What If I Don't Treat My PSA-Detected Prostate Cancer? Answers from Three Natural History Models

    NARCIS (Netherlands)

    Gulati, Roman; Wever, Elisabeth M.; Tsodikov, Alex; Penson, David F.; Inoue, Lurdes Y. T.; Katcher, Jeffrey; Lee, Shih-Yuan; Heijnsdijk, Eveline A. M.; Draisma, Gerrit; de Koning, Harry J.; Etzioni, Ruth

    Background: Making an informed decision about treating a prostate cancer detected after a routine prostate-specific antigen (PSA) test requires knowledge about disease natural history, such as the chances that it would have been clinically diagnosed in the absence of screening and that it would

  12. Insulin promotes cell migration by regulating PSA-NCAM.

    Science.gov (United States)

    Monzo, Hector J; Coppieters, Natacha; Park, Thomas I H; Dieriks, Birger V; Faull, Richard L M; Dragunow, Mike; Curtis, Maurice A

    2017-06-01

    Cellular interactions with the extracellular environment are modulated by cell surface polysialic acid (PSA) carried by the neural cell adhesion molecule (NCAM). PSA-NCAM is involved in cellular processes such as differentiation, plasticity, and migration, and is elevated in Alzheimer's disease as well as in metastatic tumour cells. Our previous work demonstrated that insulin enhances the abundance of cell surface PSA by inhibiting PSA-NCAM endocytosis. In the present study we have identified a mechanism for insulin-dependent inhibition of PSA-NCAM turnover affecting cell migration. Insulin enhanced the phosphorylation of the focal adhesion kinase leading to dissociation of αv-integrin/PSA-NCAM clusters, and promoted cell migration. Our results show that αv-integrin plays a key role in the PSA-NCAM turnover process. αv-integrin knockdown stopped PSA-NCAM from being endocytosed, and αv-integrin/PSA-NCAM clusters co-labelled intracellularly with Rab5, altogether indicating a role for αv-integrin as a carrier for PSA-NCAM during internalisation. Furthermore, inhibition of p-FAK caused dissociation of αv-integrin/PSA-NCAM clusters and counteracted the insulin-induced accumulation of PSA at the cell surface and cell migration was impaired. Our data reveal a functional association between the insulin/p-FAK-dependent regulation of PSA-NCAM turnover and cell migration through the extracellular matrix. Most importantly, they identify a novel mechanism for insulin-stimulated cell migration. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Baseline PSA in a Spanish male population aged 40-49 years anticipates detection of prostate cancer.

    Science.gov (United States)

    Angulo, J C; Viñas, M A; Gimbernat, H; Fata, F Ramón de; Granados, R; Luján, M

    2015-12-01

    We researched the usefulness of optimizing prostate cancer (PC) screening in our community using baseline PSA readings in men between 40-49 years of age. A retrospective study was performed that analyzed baseline PSA in the fifth decade of life and its ability to predict the development of PC in a population of Madrid (Spain). An ROC curve was created and a cutoff was proposed. We compared the evolution of PSA from baseline in patients with consecutive readings using the Friedman test. We established baseline PSA ranges with different risks of developing cancer and assessed the diagnostic utility of the annual PSA velocity (PSAV) in this population. Some 4,304 men aged 40-49 years underwent opportunistic screening over the course of 17 years, with at least one serum PSA reading (6,001 readings) and a mean follow-up of 57.1±36.8 months. Of these, 768 underwent biopsy of some organ, and 104 underwent prostate biopsy. Fourteen patients (.33%) were diagnosed with prostate cancer. The median baseline PSA was .74 (.01-58.5) ng/mL for patients without PC and 4.21 (.76-47.4) ng/mL for those with PC. The median time from the reading to diagnosis was 26.8 (1.5-143.8) months. The optimal cutoff for detecting PC was 1.9ng/mL (sensitivity, 92.86%; specificity, 92.54%; PPV, 3.9%; NPV, 99.97%), and the area under the curve was 92.8%. In terms of the repeated reading, the evolution of the PSA showed no statistically significant differences between the patients without cancer (p=.56) and those with cancer (P=.64). However, a PSAV value >.3ng/mL/year revealed high specificity for detecting cancer in this population. A baseline PSA level ≥1.9ng/mL in Spanish men aged 40-49 years predicted the development of PC. This value could therefore be of use for opportunistic screening at an early age. An appropriate follow-up adapted to the risk of this population needs to be defined, but an annual PSAV ≥.3ng/mL/year appears of use for reaching an early diagnosis. Copyright © 2015 AEU

  14. [Retrospective evaluation of PSA density for selection of biopsy candidates with prostate specific antigen in the gray zone].

    Science.gov (United States)

    Tochigi, T; Kawamura, S; Numahata, K; Tokuyama, S; Kuwahara, M; Horaguchi, T; Satou, S

    2001-09-01

    We examined the usefulness of prostate specific antigen density (PSAD) for selection of biopsy candidate with prostate specific antigen levels between 4.1 and 10.0 ng./ml. in prostate cancer screening retrospectively. The screening was conducted on male candidates in Natori city, aged 55 years or older, for 6 years from 1994 through 1999. We could analyze serum PSA levels and PSA density in 118 men with PSA levels between 4.1 and 10.0 ng./ml. All of 118 men underwent ultrasound guided systematic prostate biopsy regardless of findings of digital rectal examination and transrectal ultrasound. Prostate volume was estimated by transrectal ultrasound measurements using the prolate ellipse formula (pi/6 x length x width x height). PSAD was calculated by dividing serum PSA level by prostate volume. Serum PSA levels were determined by Tandem-R assay. In 118 men, twenty-five men had prostate cancer. There was no significant difference in mean PSA between those with prostate cancer and those without prostate cancer, but the difference was significant in the mean PSA density (mean 0.26 and 0.16, respectively, p PSA and PSAD demonstrated superior benefit for PSAD in 118 men. A sensitivity, a specificity, a positive predictive value and a negative predictive value of PSAD cut-off of 0.15 were 88%, 52.7%, 33.3% and 94.2%. PSAD cut-off of 0.18 showed the highest sum of sensitivity and specificity, which gave a sensitivity of 80%, a specificity of 72%, a positive predictive value of 43.5% and a negative predictive value of 93.1%. PSAD cut-off of 0.15 would seem to be preferable to cut-off of 0.18 because of less cancer missing. Although further studies are needed to determine optimal cut-off value to be used in clinical practice, PASD seems to be useful for the selection of biopsy candidates with PSA levels of 4.1 to 10.0 ng./ml. in the prostate cancer screening.

  15. Knowledge of Prostate Cancer Screening Among Native African ...

    African Journals Online (AJOL)

    Knowledge of Prostate Cancer Screening Among Native African Urban Population in Nigeria. ... Methods: It is a cross-sectional study involving 156 respondents. ... respondents are ready to pay for prostate cancer screening test by PSA assay.

  16. Participation rates in cervical cancer screening: experience in rural Northern Greece.

    Science.gov (United States)

    Vakfari, A; Gavana, M; Giannakopoulos, S; Smyrnakis, E; Benos, A

    2011-10-01

    Cervical cancer is one of the most common causes of cancer mortality among women worldwide but it is one of the most preventable cancers due to the Pap smear test. The aim of this study was to estimate the participation rate of females in screening of cervical cancer with Pap smear test. The study took place in a hospital in Rural Northern Greece during April and May 2007. Convenience sampling was performed and questionnaires were completed by 214 eligible females aged 20-64 years. One hundred and twenty four (57.9%) of the participants had had a Pap-test at some point in their lifetime. 72 of them (33.65%) had the test performed for the first time according to current guidelines. 13.6% were unaware about the recommended onset age of the test, 16.4% did not know the proper intervals, while 22.4% did not know the recommended upper age limit. 32.6% were informed by mass media, family members and friends. The take-up rates, the source of information and the setting where the examination was performed were related to age, origin, income, educational status, type of occupation and place of residence. Disparities in participation rates were detected. Special efforts should be made by National Health Services towards enhancing secondary prevention of cervical cancer by increasing participation rates of older women, those with lower educational background, females with low income, Roma, retired or unemployed and residents of rural areas.

  17. Consultation rates in cervical screening non-attenders: opportunities to increase screening uptake in GP primary care.

    Science.gov (United States)

    Lim, Anita Wey Wey; Sasieni, Peter

    2015-06-01

    To estimate the proportion of cervical screening non-attenders presenting to general practice (GP) primary care over one year. 137 practices in East London, UK. Anonymous primary care records were downloaded using EMIS web (clinical software). Cervical screening nonattendance was defined as no recorded smear in the last 3.5 years (women aged 25-49) or 5.5 years (women aged 50-64). The last three consultation entries were used to estimate the proportion of non-attenders who consulted in GP over 3 months and 1 year using the Kaplan-Meier method. Newly registered women were assessed separately. Results were calculated for each practice and the median and interquartile range (IQR) across practices are presented. Heterogeneity was assessed using funnel plots. Of 261,810 women, 224,313 (86%) had been registered for >1 year. The proportion classified as non-attenders differed between those registered for >1 year (30%, IQR 27%--35%) and within the last year (49%, IQR 40%--57%), suggesting that screening records were less up-to-date in newly registered women. A median of 32% (IQR: 27%--37%) of non-attenders presented over 3 months, and 60% (IQR: 52%--67%) over 1 year. Funnel plots of the proportion of non-attenders presenting by the number of non-attenders showed substantial variation between practices. Over half of cervical screening non-attenders present to their GP at least once a year, in over 75% of practices. This represents a good opportunity for improving coverage by offering an alternative form of screening, such as self-sampling for human papillomavirus testing. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Evaluation of Estimating Missed Answers in Conners Adult ADHD Rating Scale (Screening Version

    Directory of Open Access Journals (Sweden)

    Vahid Abootalebi

    2010-08-01

    Full Text Available "n Objective: Conners Adult ADHD Rating Scale (CAARS is among the valid questionnaires for evaluating Attention-Deficit/Hyperactivity Disorder in adults. The aim of this paper is to evaluate the validity of the estimation of missed answers in scoring the screening version of the Conners questionnaire, and to extract its principal components. "n Method: This study was performed on 400 participants. Answer estimation was calculated for each question (assuming the answer was missed, and then a Kruskal-Wallis test was performed to evaluate the difference between the original answer and its estimation. In the next step, principal components of the questionnaire were extracted by means of Principal Component Analysis (PCA. Finally the evaluation of differences in the whole groups was provided using the Multiple Comparison Procedure (MCP. Results: Findings indicated that a significant difference existed between the original and estimated answers for some particular questions. However, the results of MCP showed that this estimation, when evaluated in the whole group, did not show a significant difference with the original value in neither of the questionnaire subscales. The results of PCA revealed that there are eight principal components in the CAARS questionnaire. Conclusion: The obtained results can emphasize the fact that this questionnaire is mainly designed for screening purposes, and this estimation does not change the results of groups when a question is missed randomly. Notwithstanding this finding, more considerations should be paid when the missed question is a critical one.

  19. Cervical Abnormalities in South African Women Living With HIV With High Screening and Referral Rates.

    Science.gov (United States)

    Katz, Ingrid T; Butler, Lisa M; Crankshaw, Tamaryn L; Wright, Alexi A; Bramhill, Karen; Leone, Dominick A; Giddy, Janet; Mould, Sean

    2016-12-01

    To determine the prevalence of screening, cervical dysplasia, and malignancy on the basis of histologic diagnoses from colposcopy and large loop excision of the transformation zone among women living with HIV (WLWH) who attended an urban antiretroviral treatment (ART) clinic in KwaZulu-Natal, South Africa. We performed a retrospective cohort study to examine a random sample of 462 WLWH during a 5-year period from 2004 to 2009. Women on ART for Papanicolau test. At baseline, 237 women (54.9%) had an abnormal Papanicolau test, and of these patients, 181 (76.3%) had a Papanicolau test that qualified for further colposcopic evaluation. In addition, 115 women (63.5%) received colposcopy within a median of 39 days from referral. This yielded 74 evaluable histologic samples (64.3%), of which 21.6%, 27.0%, 27.0%, and 1.4% had cervical intraepithelial neoplasia (CIN) 1, CIN2, CIN3, and invasive cervical cancer, respectively. In a large sample of WLWH who received ART in KwaZulu-Natal, South Africa, where Papanicolau test coverage and rates of referral for colposcopy and large loop excision of the transformation zone were high, > 75% of women with evaluable histologic samples had evidence of cervical dysplasia or malignancy. These findings underscore the importance of routine cervical screening upon entry into HIV care to optimize survival.

  20. Various Applications of Power Spectrum Analysis (PSA)

    Science.gov (United States)

    2017-03-01

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  1. Increasing Fractional Doses Increases the Probability of Benign PSA Bounce in Patients Undergoing Definitive HDR Brachytherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hauck, Carlin R.; Ye, Hong; Chen, Peter Y.; Gustafson, Gary S.; Limbacher, Amy; Krauss, Daniel J., E-mail: Daniel.krauss@beaumont.edu

    2017-05-01

    Purpose: Prostate-specific antigen (PSA) bounce is a temporary elevation of the PSA level above a prior nadir. The purpose of this study was to determine whether the frequency of a PSA bounce following high-dose-rate (HDR) interstitial brachytherapy for the treatment of prostate cancer is associated with individual treatment fraction size. Methods and Materials: Between 1999 and 2014, 554 patients underwent treatment of low- or intermediate-risk prostate cancer with definitive HDR brachytherapy as monotherapy and had ≥3 subsequent PSA measurements. Four different fraction sizes were used: 950 cGy × 4 fractions, 1200 cGy × 2 fractions, 1350 cGy × 2 fractions, 1900 cGy × 1 fraction. Four definitions of PSA bounce were applied: ≥0.2, ≥0.5, ≥1.0, and ≥2.0 ng/mL above the prior nadir with a subsequent return to the nadir. Results: The median follow-up period was 3.7 years. The actuarial 3-year rate of PSA bounce for the entire cohort was 41.3%, 28.4%, 17.4%, and 6.8% for nadir +0.2, +0.5, +1.0, and +2.0 ng/mL, respectively. The 3-year rate of PSA bounce >0.2 ng/mL was 42.2%, 32.1%, 41.0%, and 59.1% for the 950-, 1200-, 1350-, and 1900-cGy/fraction levels, respectively (P=.002). The hazard ratio for bounce >0.2 ng/mL for patients receiving a single fraction of 1900 cGy compared with those receiving treatment in multiple fractions was 1.786 (P=.024). For patients treated with a single 1900-cGy fraction, the 1-, 2-, and 3-year rates of PSA bounce exceeding the Phoenix biochemical failure definition (nadir +2 ng/mL) were 4.5%, 18.7%, and 18.7%, respectively, higher than the rates for all other administered dose levels (P=.025). Conclusions: The incidence of PSA bounce increases with single-fraction HDR treatment. Knowledge of posttreatment PSA kinetics may aid in decision making regarding management of potential biochemical failures.

  2. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Science.gov (United States)

    2011-01-01

    Background Tuberculosis (TB) in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas outlined in this study should

  3. A comparative examination of tuberculosis immigration medical screening programs from selected countries with high immigration and low tuberculosis incidence rates

    Directory of Open Access Journals (Sweden)

    Sagebiel Daniel

    2011-01-01

    Full Text Available Abstract Background Tuberculosis (TB in migrants is an ongoing challenge in several low TB incidence countries since a large proportion of TB in these countries occurs in migrants from high incidence countries. To meet these challenges, several countries utilize TB screening programs. The programs attempt to identify and treat those with active and/or infectious stages of the disease. In addition, screening is used to identify and manage those with latent or inactive disease after arrival. Between nations, considerable variation exists in the methods used in migration-associated TB screening. The present study aimed to compare the TB immigration medical examination requirements in selected countries of high immigration and low TB incidence rates. Methods Descriptive study of immigration TB screening programs Results 16 out of 18 eligible countries responded to the written standardized survey and phone interview. Comparisons in specific areas of TB immigration screening programs included authorities responsible for TB screening, the primary objectives of the TB screening program, the yield of detection of active TB disease, screening details and aspects of follow up for inactive pulmonary TB. No two countries had the same approach to TB screening among migrants. Important differences, common practices, common problems, evidence or lack of evidence for program specifics were noted. Conclusions In spite of common goals, there is great diversity in the processes and practices designed to mitigate the impact of migration-associated TB among nations that screen migrants for the disease. The long-term goal in decreasing migration-related introduction of TB from high to low incidence countries remains diminishing the prevalence of the disease in those high incidence locations. In the meantime, existing or planned migration screening programs for TB can be made more efficient and evidenced based. Cooperation among countries doing research in the areas

  4. Racial and ethnic disparities in U.S. cancer screening rates

    Science.gov (United States)

    The percentage of U.S. citizens screened for cancer remains below national targets, with significant disparities among racial and ethnic populations, according to the first federal study to identify cancer screening disparities among Asian and Hispanic gr

  5. Prostate-specific antigen velocity in a prospective prostate cancer screening study of men with genetic predisposition

    DEFF Research Database (Denmark)

    Mikropoulos, Christos; Selkirk, Christina G Hutten; Saya, Sibel

    2018-01-01

    BACKGROUND: Prostate-specific antigen (PSA) and PSA-velocity (PSAV) have been used to identify men at risk of prostate cancer (PrCa). The IMPACT study is evaluating PSA screening in men with a known genetic predisposition to PrCa due to BRCA1/2 mutations. This analysis evaluates the utility of PS...

  6. The role of the percentage free PSA in the diagnosis of prostate ...

    African Journals Online (AJOL)

    K.H. Tijani

    2016-12-24

    Dec 24, 2016 ... Blood samples were collected from these selected patients for repeat tPSA and free PSA (fPSA) thereafter, analyzed within 24 h of sample collection. The analytical procedure used for determination of tPSA and fPSA assay was the Hybritech. Paramagnetic Particle Two-Site Immunoenzymatic (“Sandwich”).

  7. Neonatal hearing screening of high-risk infants using automated auditory brainstem response: a retrospective analysis of referral rates.

    LENUS (Irish Health Repository)

    McGurgan, I J

    2013-10-07

    The past decade has seen the widespread introduction of universal neonatal hearing screening (UNHS) programmes worldwide. Regrettably, such a programme is only now in the process of nationwide implementation in the Republic of Ireland and has been largely restricted to one screening modality for initial testing; namely transient evoked otoacoustic emissions (TEOAE). The aim of this study is to analyse the effects of employing a different screening protocol which utilises an alternative initial test, automated auditory brainstem response (AABR), on referral rates to specialist audiology services.

  8. Physical activity, screen time and self-rated health and mental health in Canadian adolescents.

    Science.gov (United States)

    Herman, Katya M; Hopman, Wilma M; Sabiston, Catherine M

    2015-04-01

    Physical activity (PA) and screen time (ST) are associated with self-rated health (SRH) in adults; however, SRH has been less studied among youth, and information about self-rated mental health (SRMH) is lacking. This study examined the associations of PA and ST with SRH and SRMH among adolescents. Cross-sectional data from the 2011-2012 Canadian Community Health Survey included 7725 participants aged 12-17years, representing 1,820,560 Canadian adolescents. Associations of self-reported PA and ST to SRH and SRMH were assessed, controlling for age, race/ethnicity, smoking, highest household education and weight status. Excellent/very good SRH was reported by 78% of active vs. 62% of inactive adolescents, and 77% of those meeting vs. 70% of those exceeding ST guidelines (both pactive vs. 76% of inactive adolescents, and 84% of those meeting vs. 78% of those exceeding ST guidelines (both phealth perceptions among Canadian adolescents. Interventions should consider health perceptions in addition to biomedical outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Rates of Delirium Diagnosis Do Not Improve with Emergency Risk Screening: Results of the Emergency Department Delirium Initiative Trial.

    Science.gov (United States)

    Arendts, Glenn; Love, Jennefer; Nagree, Yusuf; Bruce, David; Hare, Malcolm; Dey, Ian

    2017-08-01

    To determine whether a bundled risk screening and warning or action card system improves formal delirium diagnosis and person-centered outcomes in hospitalized older adults. Prospective trial with sequential introduction of screening and interventional processes. Two tertiary referral hospitals in Australia. Individuals aged 65 and older presenting to the emergency department (ED) and not requiring immediate resuscitation (N = 3,905). Formal ED delirium screening algorithm and use of a risk warning card with a recommended series of actions for the prevention and management of delirium during the subsequent admission MEASUREMENTS: Delirium diagnosis at hospital discharge, proportion discharged to new assisted living arrangements, in-hospital complications (use of sedation, falls, aspiration pneumonia, death), hospital length of stay. Participants with a positive risk screen were significantly more likely (relative risk = 6.0, 95% confidence interval = 4.9-7.3) to develop delirium, and the proportion of at-risk participants with a positive screen was constant across three study phases. Delirium detection rate in participants undergoing the final intervention (Phase 3) was 12.1% (a 2% absolute and 17% relative increase from the baseline rate) but this was not statistically significant (P = .29), and a similar relative increase was seen over time in participants not receiving the intervention CONCLUSION: A risk screening and warning or action card intervention in the ED did not significantly improve rates of delirium detection or other important outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  10. PROSTATE CANCER SCREENING IN GHANA -

    African Journals Online (AJOL)

    In Ghana and most African countries, prostate cancer is the most common cancer in males after hepatocellnlar carcinoma. Whereas in the advanced countries, screening for prostate specific anti- gen (PSA) has led to early detection and management of the disease, screening has been very low in Ghana, thus leading to low ...

  11. Comparison of mean prostate-specific antigen (PSA) values ...

    African Journals Online (AJOL)

    All subjects were non-obese, had no prostatic symptoms and were not masturbating. Standard technique of specimen collection, processing and analysis of PSA values using Immunoassay technique were applied. The celibate group had a mean PSA value of 2.6±0.2ng/ml, while the sexually-active group had a mean PSA ...

  12. Screening of TB Actives for Activity against Nontuberculous Mycobacteria Delivers High Hit Rates

    Directory of Open Access Journals (Sweden)

    Jian Liang Low

    2017-08-01

    Full Text Available The prevalence of lung disease due to infections with nontuberculous mycobacteria (NTM has been increasing and surpassed tuberculosis (TB in some countries. Treatment outcomes are often unsatisfactory, highlighting an urgent need for new anti-NTM medications. Although NTM in general do not respond well to TB specific drugs, the similarities between NTM and Mycobacterium tuberculosis at the molecular and cell structural level suggest that compound libraries active against TB could be leveraged for NTM drug discovery. Here we tested this hypothesis. The Pathogen Box from the Medicines for Malaria Venture (MMV is a collection of 400 diverse drug-like compounds, among which 129 are known to be active against M. tuberculosis. By screening this compound collection against two NTM species, Mycobacterium abscessus and Mycobacterium avium, we showed that indeed the hit rates for NTM among TB active compounds is significantly higher compared to compounds that are not active against TB. MIC/dose response confirmation identified 10 top hits. Bactericidal activity determination demonstrated attractive potency for a subset of the confirmed hits. In vivo pharmacokinetic profiling showed that some of the compounds present reasonable starting points for medicinal chemistry programs. Three of the top hits were oxazolidinones, suggesting the potential for repositioning this class of protein synthesis inhibitors to replace linezolid which suffers from low potency. Two hits were inhibitors of the trehalose monomycolate transporter MmpL3, suggesting that this transmembrane protein may be an attractive target for NTM. Other hits are predicted to target a range of functions, including cell division (FtsZ, DNA gyrase (GyrB, dihydrofolate reductase, RNA polymerase and ABC transporters. In conclusion, our study showed that screening TB active compounds for activity against NTM resulted in high hit rates, suggesting that this may be an attractive approach to kick start NTM

  13. Prostate health index significantly reduced unnecessary prostate biopsies in patients with PSA 2-10 ng/mL and PSA >10 ng/mL: Results from a Multicenter Study in China.

    Science.gov (United States)

    Na, Rong; Ye, Dingwei; Qi, Jun; Liu, Fang; Helfand, Brian T; Brendler, Charles B; Conran, Carly A; Packiam, Vignesh; Gong, Jian; Wu, Yishuo; Zheng, Siqun L; Mo, Zengnan; Ding, Qiang; Sun, Yinghao; Xu, Jianfeng

    2017-08-01

    The performance of prostate health index (phi) in predicting prostate biopsy outcomes has been well established for patients with prostate-specific antigen (PSA) values between 2 and 10 ng/mL. However, the performance of phi remains unknown in patients with PSA >10 ng/mL, the vast majority in Chinese biopsy patients. We aimed to assess the ability of phi to predict prostate cancer (PCa) and high-grade disease (Gleason Score ≥7) on biopsy in a Chinese population. This is a prospective, observational, multi-center study of consecutive patients who underwent a transrectal ultrasound guided prostate biopsy at four hospitals in Shanghai, China from August 2013 to December 2014. In the cohort of 1538 patients, the detection rate of PCa was 40.2%. phi had a significantly better predictive performance for PCa than total PSA (tPSA). The areas under the receiver operating characteristic curve (AUC) were 0.90 and 0.79 for phi and tPSA, respectively, P 10 ng/mL (N = 838, 54.5%). The detection rates of PCa were 35.9% and 57.7% in patients with tPSA 10.1-20 and 20.1-50 ng/mL, respectively. The AUCs of phi (0.79 and 0.89, for these two groups, respectively) were also significantly higher than tPSA (0.57 and 0.63, respectively), both P 10 ng/mL). © 2017 Wiley Periodicals, Inc.

  14. PSA testing for prostate cancer: an online survey of the views and reported practice of General Practitioners in the UK

    Directory of Open Access Journals (Sweden)

    Elwyn Glyn

    2005-06-01

    Full Text Available Abstract Background The role of Prostate Specific Antigen (PSA testing in the early detection of prostate cancer is controversial. Current UK policy stipulates that any man who wishes to have a PSA test should have access to the test, provided he has been given full information about the benefits and limitations of testing. This study aimed to determine UK GPs' current reported practice regarding PSA testing, and their views towards informed decision-making and PSA testing. Method Online questionnaire survey, with a sample of 421 GPs randomly selected from a database of GPs across the UK. Results 95% (400/421 of GPs responded. 76% of GPs reported having performed a PSA test for an asymptomatic man at least once in the previous three months, with 13% reported having tested more than five men in this period. A majority of GPs reported they would do a PSA test for men presenting with a family history and requesting a test, for asymptomatic men requesting a test and also for men presenting with lower urinary tract symptoms. Reported testing rates were highest for men with a family history. Amongst men with lower urinary tract symptoms and men with no symptoms, reported testing rates were significantly higher for older than younger men. The majority of GPs expressed support for the current policy (67%, and favoured both the general practitioner and the man being involved in the decision making process (83%. 90% of GPs indicated that they would discuss the benefits and limitation of testing with the man, with most (61% preferring to ask the man to make a further appointment if he decides to be tested. Conclusion This study indicates that PSA testing in asymptomatic men is a regular occurrence in the UK, and that there is general support from GPs for the current policy of making PSA tests available to 'informed' men who are concerned about prostate cancer. While most GPs indicated they would discuss the benefits and limitations prior to PSA testing

  15. Danish General Practitioners' Use of Prostate-Specific Antigen in Opportunistic Screening for Prostate Cancer

    DEFF Research Database (Denmark)

    Jessen, Kasper; Søndergaard, Jens; Larsen, Pia Veldt

    2013-01-01

    Background. The use of prostate-specific antigen test has markedly increased in Danish general practice in the last decade. Despite the national guidelines advice against PSA screening, opportunistic screening is supposed to be the primary reason for this increased number of PSA tests performed...... be potential reasons for measuring PSA for asymptomatic patients. Almost all GPs stated that a PSA measurement is indicated for symptomatic 49- and 78-year-old men, respectively, 98.9% and 93.8%. Conclusion. Opportunistic PC screening is being performed in general practice to a high degree. Hence, current...

  16. Associations of County-level Radiologist and Mammography Facility Supply with Screening Mammography Rates in the United States.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Moy, Linda; Fleming, Margaret M; Duszak, Richard

    2018-01-17

    The present study aims to assess associations of Medicare beneficiary screening mammography rates with local mammography facility and radiologist availability. Mammography screening rates for Medicare fee-for-service beneficiaries were obtained for US counties using the County Health Rankings data set. County-level certified mammography facility counts were obtained from the United States Food and Drug Administration. County-level mammogram-interpreting radiologist and breast imaging subspecialist counts were determined using Centers for Medicare & Medicaid Services fee-for-service claims files. Spearman correlations and multivariable linear regressions were performed using counties' facility and radiologist counts, as well as counts normalized to counties' Medicare fee-for-service beneficiary volume and land area. Across 3035 included counties, average screening mammography rates were 60.5% ± 8.2% (range 26%-88%). Correlations between county-level screening rates and total mammography facilities, facilities per 100,000 square mile county area, total mammography-interpreting radiologists, and mammography-interpreting radiologists per 100,000 county-level Medicare beneficiaries were all weak (r = 0.22-0.26). Correlations between county-level screening rates and mammography rates per 100,000 Medicare beneficiaries, total breast imaging subspecialist radiologists, and breast imaging subspecialist radiologists per 100,000 Medicare beneficiaries were all minimal (r = 0.06-0.16). Multivariable analyses overall demonstrated radiologist supply to have a stronger independent effect than facility supply, although effect sizes remained weak for both. Mammography facility and radiologist supply-side factors are only weakly associated with county-level Medicare beneficiary screening mammography rates, and as such, screening mammography may differ from many other health-care services. Although efforts to enhance facility and radiologist supply may be helpful

  17. Systematic dysphagia screening and dietary modifications to reduce stroke-associated pneumonia rates in a stroke-unit.

    Science.gov (United States)

    Teuschl, Yvonne; Trapl, Michaela; Ratajczak, Paulina; Matz, Karl; Dachenhausen, Alexandra; Brainin, Michael

    2018-01-01

    While formal screening for dysphagia following acute stroke is strongly recommended, there is little evidence on how multi-consistency screening and dietary modifications affect the rate of stroke-associated pneumonia (SAP). This observational study reports which factors affect formal screening on a stroke-unit and how dietary recommendations relate to SAP. Analyses from a database including 1394 patients admitted with acute stroke at our stroke-unit in Austria between 2012 and 2014. Dietary modifications were performed following the recommendations from the Gugging Swallowing Screen (GUSS). Patients evaluated with GUSS were compared to the unscreened patients. Overall, 993 (71.2%) patients were screened with GUSS; of these 50 (5.0%) developed SAP. In the 401 unscreened patients, the SAP rate was similar: 22 (5.5%). Multivariable analysis showed that either mild to very mild strokes or very severe strokes were less likely to undergo formal screening. Older age, pre-existing disability, history of hypertension, atrial fibrillation, stroke severity, cardiological and neurological complications, nasogastric tubes, and intubation were significant markers for SAP. Out of 216 patients, 30 (13.9%) developed SAP in spite of receiving nil per mouth (NPO). The routine use of GUSS is less often applied in either mild strokes or very severe strokes. While most patients with high risk of SAP were identified by GUSS and assigned to NPO, dietary modifications could not prevent SAP in 1 of 7 cases. Other causes of SAP such as silent aspiration, bacteraemia or central breathing disturbances should be considered.

  18. Policy and System Approach (PSA: A primer

    Directory of Open Access Journals (Sweden)

    Chandrakant Lahariya

    2017-01-01

    Full Text Available A number of public health challenges have emerged at global and national level in the last two decades. The response to these challenges has rarely been swift and often “knee-jerk.” The national and state level program officials responsible for the activities often apportion the blame on weak health systems or fragmented health service delivery mechanisms, amongst other. In India, the viral illnesses (including those due to dengue and chikungunya are becoming the increasing realities. The Public health response of early identification, disease surveillance, reporting and the preventive and curative measures, remains suboptimal. The health challenges which require multidimensional interventions are usuallyattempted to be resolved through piece meal solutions. This article proposes “policy and system approach (PSA,” combining concepts of “Health in all policies” for intersectoral coordination and “health system approach” for intra-sectoral tackling of the emerging and existing health challenges.

  19. Daily Pill Can Prevent HIV PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2015-11-24

    This 60 second public service announcement (PSA) is based on the November 24, 2015 CDC Vital Signs report. Preexposure prophylaxis, or PrEP, is a daily medicine that can be used to prevent getting HIV. PrEP is for people who don’t have HIV but who are at very high risk for getting it from sex or injection drug use. Unfortunately, many people who can benefit from PrEP aren’t taking it.  Created: 11/24/2015 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 11/24/2015.

  20. Prognostic implications of immediate PSA response to early salvage radiotherapy.

    Science.gov (United States)

    Turner I I, Robert M; Yabes, Jonathan G; Woldemichael, Elen; Deutsch, Melvin M; Smith, Ryan P; Werner, Robert S; Jacobs, Bruce L; Nelson, Joel B

    2016-12-01

    Up to 25% of men with prostate cancer who undergo radical prostatectomy will recur. In this setting, salvage radiotherapy may cure patients with local recurrence, but is unable to cure those with occult metastatic disease. The objective of this study is to examine how prostate-specific antigen (PSA) response to radiotherapy predicts subsequent disease progression and survival. Using a prospectively populated database of 3089 men who underwent open radical prostatectomy, 212 patients (7%) were identified who received early salvage radiotherapy for biochemical recurrence. The main outcome was time to disease progression after salvage radiotherapy. Patients were stratified by PSA response after radiotherapy: 1) PSA radiotherapy at a median PSA of 0.20 ng/mL (IQR 0.10-0.30 ng/mL). At a median follow up of 47.3 months, a total of 52 (25%) patients experienced disease progression. On multivariable analysis, both persistent PSA (HR 5.12; 95% CI 1.98-13.23) and rising PSA (HR 16.55; 95% CI 6.61-41.48) were associated with increased risk of disease progression compared to those with PSA radiotherapy PSA, Gleason score, margin status, stage, and time to radiotherapy. Only rising PSA was associated with an increased risk of cancer-specific and all-cause mortality. PSA response is associated with the risk of disease progression following salvage radiotherapy. This information can be used to counsel patients on the potential need for additional therapy and identify those at greatest risk for progression and cancer-related mortality.

  1. [Participation rates in the third round (2006-2007) of the breast cancer screening program in Hungary].

    Science.gov (United States)

    Boncz, Imre; Döbrõssy, Lajos; Péntek, Zoltán; Kovács, Attila; Budai, András; Vajda, Réka; Sebestyén, Andor

    2013-09-01

    Organised, nationwide screening for breast cancer with mammography in the age group of 45-65 years with 2 years screening interval started in Hungary in January 2002. The aim of this study is to analyse the attendance rate of breast screening programme for the 2006/2007 years, including the analysis of the ratio of screening and diagnostic mammography examinations. The data derive from the financial database of the National Health Insurance Fund Administration (NHIFA) covering the 8 years period between 2000 and 2007. The ratio of women in the age group of 45-65 years was calculated having either a screening mammography or a diagnostic mammography. The analysis was carried out for the years 2000-2001 before and 2006-2007 after the implementation of nationwide organised programme. In the years 2000-2001 7.26% of the women aged 45-65 years had an opportunistic screening mammography while in 2006-2007 29.4% of the target population had screening mammography within the organised programme. During the same periods 19.8% (2000-2001) and 21.8% (2006-2007) of women aged 45-65 years had a diagnostic mammography. Thus the total (screening and diagnostic) coverage of mammography increased from 26.2% (2000-2001) to 49.7% (2006-2007). The attendance of the Hungarian organised breast cancer screening programme slightly declined in 2006-2007 compared to 2002-2003/2004-2005, and to achieve the expected results in mortality decrease a further improvement of the uptake is necessary.

  2. Low hepatitis C antibody screening rates among an insured population of Tennessean Baby Boomers.

    Directory of Open Access Journals (Sweden)

    James G Carlucci

    Full Text Available Chronic Hepatitis C Virus (HCV infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers" have relatively high prevalence of chronic HCV infection, prompting recommendations that all Baby Boomers be screened for HCV. If chronic HCV is confirmed, evaluation for antiviral treatment should be performed. Direct-acting antivirals can cure more than 90% of people with chronic HCV. This sequence of services can be referred to as the HCV "cascade of cure" (CoC. The Tennessee (TN Department of Health (TDH and a health insurer with presence in TN aimed to determine the proportion of Baby Boomers who access HCV screening services and appropriately navigate the HCV CoC in TN.TDH surveillance data and insurance claim records were queried to identify the cohort of Baby Boomers eligible for HCV testing. Billing codes and pharmacy records from 2013 through 2015 were used to determine whether HCV screening and other HCV-related services were provided. The proportion of individuals accessing HCV screening and other steps along the HCV CoC was determined. Multivariable analyses were performed to identify factors associated with HCV screening and treatment.Among 501,388 insured Tennessean Baby Boomers, 7% were screened for HCV. Of the 40,019 who received any HCV-related service, 86% were screened with an HCV antibody test, 20% had a confirmatory HCV PCR, 9% were evaluated for treatment, and 4% were prescribed antivirals. Hispanics were more likely to be screened and treated for HCV than non-Hispanic whites. HCV screening was more likely to occur in the Nashville-Davidson region than in other regions of TN, but there were regional variations in HCV treatment.Many insured Tennessean Baby Boomers do not access HCV screening services, despite national recommendations. Demographic and regional differences in uptake along the HCV CoC should inform public health interventions aimed at mitigating the effects of chronic

  3. Low hepatitis C antibody screening rates among an insured population of Tennessean Baby Boomers.

    Science.gov (United States)

    Carlucci, James G; Farooq, Syeda A; Sizemore, Lindsey; Rickles, Michael; Cosley, Brandon; McCormack, Leigh; Wester, Carolyn

    2017-01-01

    Chronic Hepatitis C Virus (HCV) infection is common and can cause liver disease and death. Persons born from 1945 through 1965 ("Baby Boomers") have relatively high prevalence of chronic HCV infection, prompting recommendations that all Baby Boomers be screened for HCV. If chronic HCV is confirmed, evaluation for antiviral treatment should be performed. Direct-acting antivirals can cure more than 90% of people with chronic HCV. This sequence of services can be referred to as the HCV "cascade of cure" (CoC). The Tennessee (TN) Department of Health (TDH) and a health insurer with presence in TN aimed to determine the proportion of Baby Boomers who access HCV screening services and appropriately navigate the HCV CoC in TN. TDH surveillance data and insurance claim records were queried to identify the cohort of Baby Boomers eligible for HCV testing. Billing codes and pharmacy records from 2013 through 2015 were used to determine whether HCV screening and other HCV-related services were provided. The proportion of individuals accessing HCV screening and other steps along the HCV CoC was determined. Multivariable analyses were performed to identify factors associated with HCV screening and treatment. Among 501,388 insured Tennessean Baby Boomers, 7% were screened for HCV. Of the 40,019 who received any HCV-related service, 86% were screened with an HCV antibody test, 20% had a confirmatory HCV PCR, 9% were evaluated for treatment, and 4% were prescribed antivirals. Hispanics were more likely to be screened and treated for HCV than non-Hispanic whites. HCV screening was more likely to occur in the Nashville-Davidson region than in other regions of TN, but there were regional variations in HCV treatment. Many insured Tennessean Baby Boomers do not access HCV screening services, despite national recommendations. Demographic and regional differences in uptake along the HCV CoC should inform public health interventions aimed at mitigating the effects of chronic HCV.

  4. The Chances of Subsequent Cancer Detection in Patients with a PSA > 20 ng/ml and an Initial Negative Biopsy

    Directory of Open Access Journals (Sweden)

    Nadeem Shaida

    2009-01-01

    Full Text Available Transrectal ultrasound (TRUS–guided prostate biopsy is known to carry a significant false-negative rate, leading some patients to have multiple biopsies. We investigated cancer detection rates in patients with a PSA >20 ng/ml and a negative initial biopsy. We reviewed our database of 2396 TRUS-guided biopsies done between 1997 and 2002 in order to give a follow-up of at least 6 years. PSA, PSA density (PSAD, PSA velocity (PSAV, prostate volume, and DRE findings were analysed in relation to cancer status. Of the patients, 388 (16% had a PSA >20 ng/ml, including 99 (26% with benign biopsies. Of those, 67 were rebiopsied, including 19 (28% with cancer on the first rebiopsy and four (6% on further biopsies. PSAD, DRE, and volume significantly differed between rebiopsied patients with and without cancer (p 20 ng/ml and have an initial negative biopsy have a high chance of malignancy being detected on a second biopsy. However, if a second biopsy is also negative, then the chances of subsequent biopsies showing signs of cancer are very low if the DRE is normal and particularly if the PSAD is >0.35 ng/ml/cm3.

  5. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up.

    LENUS (Irish Health Repository)

    Hambly, Niamh M

    2011-01-01

    Background parenchymal enhancement on breast MRI refers to normal enhancement of the patient\\'s fibroglandular tissue. The aim of this study was to determine the effect of background parenchymal enhancement on short-interval follow-up, biopsy, and cancer detection rate on baseline screening MRI in a high-risk group.

  6. Lille Apathy Rating Scale and MDS-UPDRS for Screening Apathy in Parkinson's Disease.

    Science.gov (United States)

    Weintraut, Rita; Karádi, Kázmér; Lucza, Tivadar; Kovács, Márton; Makkos, Attila; Janszky, József; Kovács, Norbert

    2016-01-01

    Apathy is a syndrome characterized primarily by lack of motivation which may be associated with cognitive, affective and behavioral changes. Although the Lille Apathy Scale (LARS) has been extensively utilized in PD for detecting apathy and testing the effectiveness of specific therapeutic interventions, the highly variable cut-off values (between -11 and -22 points) ensures the applicability of the LARS degree of difficulty as a superb screening tool. The aim of this study is to determine more reliable threshold values based on the neuropsychiatric status of patients. Depression was assessed utilizing the Montgomery-Asberg Depression Rating Scale and neurocognitive status by Addenbrooke's Cognitive Examination. The presence of apathy was assessed by the proposed diagnostic criteria of Drijgers et al, and graded by both LARS and the 'Apathy' item of MDS-UPDRS. Based on multivariate regression analysis, we revealed the neurocognitive status, severity of depression, and also gender while applying dosage of dopamine agonists to determine the degree of patient apathy. Based on whether or not depression and neurocognitive disorders were indeed present, we established four different threshold values for the LARS: patients with normal cognition and without depression: -22.5; patients with normal cognition and with depression: -18.5; patients with NCD and without depression: -19.5; patients with NCD and with depression: -14.5. The LARS and the 'Apathy' item of MDS-UPDRS were confirmed to be potentially operational, beneficial and easy-to-assess instruments for detecting apathy syndrome in PD. However, there is no universal threshold value for the LARS suitable in all types of Parkinson's patients.

  7. Prostate cancer awareness and screening among male public servants in Anambra State, Nigeria

    Directory of Open Access Journals (Sweden)

    C.K. Oranusi

    2012-06-01

    Conclusion: Despite a high awareness of PCa among public servants in Anambra State, Nigeria, a very small proportion of these men had undergone PSA screening. To achieve a stage migration in PCa detection in Nigeria, early detection using PSA screening should be actively driven by health personnel using the media.

  8. Increasing live birth rate by preimplantation genetic screening of pooled polar bodies using array comparative genomic hybridization.

    Directory of Open Access Journals (Sweden)

    Michael Feichtinger

    Full Text Available Meiotic errors during oocyte maturation are considered the major contributors to embryonic aneuploidy and failures in human IVF treatment. Various technologies have been developed to screen polar bodies, blastomeres and trophectoderm cells for chromosomal aberrations. Array-CGH analysis using bacterial artificial chromosome (BAC arrays is widely applied for preimplantation genetic diagnosis (PGD using single cells. Recently, an increase in the pregnancy rate has been demonstrated using array-CGH to evaluate trophectoderm cells. However, in some countries, the analysis of embryonic cells is restricted by law. Therefore, we used BAC array-CGH to assess the impact of polar body analysis on the live birth rate. A disadvantage of polar body aneuploidy screening is the necessity of the analysis of both the first and second polar bodies, resulting in increases in costs for the patient and complex data interpretation. Aneuploidy screening results may sometimes be ambiguous if the first and second polar bodies show reciprocal chromosomal aberrations. To overcome this disadvantage, we tested a strategy involving the pooling of DNA from both polar bodies before DNA amplification. We retrospectively studied 351 patients, of whom 111 underwent polar body array-CGH before embryo transfer. In the group receiving pooled polar body array-CGH (aCGH analysis, 110 embryos were transferred, and 29 babies were born, corresponding to live birth rates of 26.4% per embryo and 35.7% per patient. In contrast, in the control group, the IVF treatment was performed without preimplantation genetic screening (PGS. For this group, 403 embryos were transferred, and 60 babies were born, resulting in live birth rates of 14.9% per embryo and 22.7% per patient. In conclusion, our data show that in the aCGH group, the use of aneuploidy screening resulted in a significantly higher live birth rate compared with the control group, supporting the benefit of PGS for IVF couples in

  9. Association of Polymorphisms in the Prostate-Specific Antigen (PSA) Gene Promoter with Serum PSA Level and PSA Changes after Dutasteride Treatment in Korean Men with Benign Prostatic Hypertrophy.

    Science.gov (United States)

    Park, Sung Woon; Kim, Chul Sung; Lee, Gilho

    2010-12-01

    Studies of genetic variation in the prostate-specific antigen (PSA) gene have improved the diagnostic accuracy of PSA for diagnosing prostate diseases in Caucasians. However, the reference ranges and pharmacokinetics of PSA differ significantly according to race. Therefore, we evaluated the association between genetic variations in the PSA promoter area and benign prostatic hyperplasia (BPH) phenotypes in Korean BPH patients. One hundred twenty-one men were enrolled. The initial serum PSA level, prostate size, and PSA changes at 3 months after treatment with dutasteride were determined. We amplified the promoter region of the PSA gene (nucleotide positions -158 to -356 and -5217 to -5429) and sequenced the products. Three relatively well characterized single-nucleotide polymorphisms (SNPs; rs3760722, rs266867, and rs266868), six uncharacterized SNPs (rs17554958, rs266882, rs4802754, rs2739448, rs2569733, and rs17526278), and one novel SNP (nucleotide position -5402) were found. There were no statistically significant correlations between any of the SNPs of the PSA promoter area and age-adjusted prostate sizes, initial PSA levels, or PSA variations after 3 months of dutasteride treatment. SNPs in the PSA promoter area were not associated with BPH phenotypes. We could not predict serum PSA changes after dutasteride treatment on the basis of PSA promoter genotype in Korean patients with BPH.

  10. Serenoa repens (Permixon) inhibits the 5alpha-reductase activity of human prostate cancer cell lines without interfering with PSA expression.

    Science.gov (United States)

    Habib, Fouad K; Ross, Margaret; Ho, Clement K H; Lyons, Valerie; Chapman, Karen

    2005-03-20

    The phytotherapeutic agent Serenoa repens is an effective dual inhibitor of 5alpha-reductase isoenzyme activity in the prostate. Unlike other 5alpha-reductase inhibitors, Serenoa repens induces its effects without interfering with the cellular capacity to secrete PSA. Here, we focussed on the possible pathways that might differentiate the action of Permixon from that of synthetic 5alpha-reductase inhibitors. We demonstrate that Serenoa repens, unlike other 5alpha-reductase inhibitors, does not inhibit binding between activated AR and the steroid receptor-binding consensus in the promoter region of the PSA gene. This was shown by a combination of techniques: assessment of the effect of Permixon on androgen action in the LNCaP prostate cancer cell line revealed no suppression of AR and maintenance of PSA protein expression at control levels. This was consistent with reporter gene experiments showing that Permixon failed to interfere with AR-mediated transcriptional activation of PSA and that both testosterone and DHT were equally effective at maintaining this activity. Our results demonstrate that despite Serenoa repens effective inhibition of 5alpha-reductase activity in the prostate, it did not suppress PSA secretion. Therefore, we confirm the therapeutic advantage of Serenoa repens over other 5alpha-reductase inhibitors as treatment with the phytotherapeutic agent will permit the continuous use of PSA measurements as a useful biomarker for prostate cancer screening and for evaluating tumour progression. (c) 2004 Wiley-Liss, Inc.

  11. The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure as a Screening Tool.

    Science.gov (United States)

    Bastiaens, Leo; Galus, James

    2017-05-19

    The DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure was developed to aid clinicians with a dimensional assessment of psychopathology; however, this measure resembles a screening tool for several symptomatic domains. The objective of the current study was to examine the basic parameters of sensitivity, specificity, positive and negative predictive power of the measure as a screening tool. One hundred and fifty patients in a correctional community center filled out the measure prior to a psychiatric evaluation, including the Mini International Neuropsychiatric Interview screen. The above parameters were calculated for the domains of depression, mania, anxiety, and psychosis. The results showed that the sensitivity and positive predictive power of the studied domains was poor because of a high rate of false positive answers on the measure. However, when the lowest threshold on the Cross-Cutting Symptom Measure was used, the sensitivity of the anxiety and psychosis domains and the negative predictive values for mania, anxiety and psychosis were good. In conclusion, while it is foreseeable that some clinicians may use the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure as a screening tool, it should not be relied on to identify positive findings. It functioned well in the negative prediction of mania, anxiety and psychosis symptoms.

  12. Long-Term Effects of a Screening Intervention for Depression on Suicide Rates among Japanese Community-Dwelling Older Adults.

    Science.gov (United States)

    Oyama, Hirofumi; Sakashita, Tomoe

    2016-04-01

    To explore the long-term impact of a universal screening intervention for depression on suicide rates among older community-dwelling adults, with gender as an effect modifier. Controlled cohort study reporting long-term follow-up of previous research. Two sets of three municipalities in Japan were assigned as intervention and control regions and compared with the surrounding zone and prefecture. Intervention area residents aged 60 years and older (14,291) were invited to participate in a 2-year intervention (2005-2006). Four population-based dynamic cohorts of residents aged 65 years and older (1999-2010) were included as subjects, 6 years before and after the intervention started. At-risk residents within the intervention region (4,918) were invited for a two-step screening program; 2,552 participated in the program linked with care/support services for 2 years. An education program open to the public was held. Changes in suicide from a 6-year baseline to the 2-year intervention and a 4-year follow-up in the intervention region (11,700 adults ≥65 years) were compared with a matched control and two comparison areas using mixed-effects negative binomial regression models. Suicide rates among older adults exposed to screening were compared with those of the control region. Suicide rates in the intervention region decreased by 48%, which was significantly greater than in the three comparison areas. The program's benefits lasted longer for women than men. Screening exposure may be associated with decreased suicide risk over the 4-year follow-up. Universal screening may decrease suicide rates among older adults, with potential gender differences in treatment response. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  13. Prostate cancer in patients from rural and suburban areas – PSA value, Gleason score and presence of metastases in bone scan

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2014-11-01

    Full Text Available [b]Introduction[/b]. Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA serum value is used both as a screening tool and for staging of prostate cancer. aim. To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. [b]material[/b]. A group of 186 patients (aged: 68.38±6.16 diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. [b]methods[/b]. Analysis of all laboratory findings (including PSA value and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP labeled with Tc-99m. [b]results[/b]. In patients with a Gleason value ≤7 and a PSA value ≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (p<0.01. Correlations were established between PSA value and presence of metastases in bone scan (r=0.45, p=0.05, the number of metastases (r=0.66, p<0.01, and their presence in particular body regions. [b]conclusions[/b]. The correlation between PSA value and both presence and number of metastases confirms the usefulness of bone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA = 10 ng/ml.

  14. Effectiveness of school dental screening on stimulating dental attendance rates in Vikarabad town: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Gadde Praveen

    2014-01-01

    Full Text Available Background: The school dental screening program has been in existence from the beginning of 20 th century. Its value in encouraging attendance among school children is not fully established. Aim: The aim was to determine the effectiveness of school dental screening on stimulating dental attendance rates among school children in Vikarabad town. Objectives: (a To compare the dental attendance rates between 6-9 and 10-13 years old age groups, among male and female school children in Vikarabad town. (b To identify the type of dental treatment received by the school children. Materials and Methods: A randomized controlled trial was conducted among school children aged 6-13 years old from 16 schools that were randomly selected and divided into two groups. Eight schools had a dental screening program (study group = 300 children and had blanket referral cards and 8 schools that did not have the intervention (control group = 300. The dental attendance rates were determined after 3 months of follow-up period by evaluating the blanket referral cards for the study group and by an oral questionnaire for the control group. Results: The dental attendance rate was 27% for the study group and 18% for the control group which is statistically significant. The attendance rate was higher among 10-13 years of children both in test group and control groups. Among the children who visited the dentist, 53% in the control group and 69% from the test group got simple amalgam and glass ionomer cement restorations. Conclusion: The dental attendance rates were improved following school dental screening.

  15. Artificial neural network (ANN velocity better identifies benign prostatic hyperplasia but not prostate cancer compared with PSA velocity

    Directory of Open Access Journals (Sweden)

    Lein Michael

    2008-09-01

    Full Text Available Abstract Background To validate an artificial neural network (ANN based on the combination of PSA velocity (PSAV with a %free PSA-based ANN to enhance the discrimination between prostate cancer (PCa and benign prostate hyperplasia (BPH. Methods The study comprised 199 patients with PCa (n = 49 or BPH (n = 150 with at least three PSA estimations and a minimum of three months intervals between the measurements. Patients were classified into three categories according to PSAV and ANN velocity (ANNV calculated with the %free based ANN "ProstataClass". Group 1 includes the increasing PSA and ANN values, Group 2 the stable values, and Group 3 the decreasing values. Results 71% of PCa patients typically have an increasing PSAV. In comparison, the ANNV only shows this in 45% of all PCa patients. However, BPH patients benefit from ANNV since the stable values are significantly more (83% vs. 65% and increasing values are less frequently (11% vs. 21% if the ANNV is used instead of the PSAV. Conclusion PSAV has only limited usefulness for the detection of PCa with only 71% increasing PSA values, while 29% of all PCa do not have the typical PSAV. The ANNV cannot improve the PCa detection rate but may save 11–17% of unnecessary prostate biopsies in known BPH patients.

  16. [Salvage radiotherapy for patients with PSA relapse after radical prostatectomy: comparisons among ASTRO and Phoenix biochemical failure definitions].

    Science.gov (United States)

    Quero, L; Mongiat-Artus, P; Ravery, V; Hennequin, V; Maylin, C; Desgrandchamps, F; Hennequin, C

    2009-07-01

    Study about the efficacy of salvage radiotherapy (RT), in terms of biochemical disease free survival (bDFS), according to ASTRO and Phoenix (nadir+2) definitions, for persistent or rising PSA after radical prostatectomy. Retrospective analysis of 59 patients who underwent RT between 1990 and 2003 for PSA recurrence after radical prostatectomy. Patients received a median of 66Gy to the prostate bed with 3D or 2D RT. The main end point was bDFS according to ASTRO and Phoenix (nadir+2) definitions. Different criterion sets were analysed to calculate bDFS and pretreatment factors that might predict biochemical relapse were sought for each. After a 38-month median follow-up, the 3-year bDFS rates were: 60 and 72% for ASTRO and Phoenix (nadir+2 ng/ml) definitions respectively. According to univariate analysis, pre-RT PSA> or =1 ng/ml and seminal vesicle involvement were associated with biochemical relapse. Multivariate analysis retained only pre-RT PSA> or =1 ng/ml as an independent predictor of biochemical relapse for the two definitions. Salvage RT is an effective treatment after radical prostatectomy according to ASTRO or Phoenix definitions. Only pre-RT PSA> or =1 ng/ml predicted relapse.

  17. PSA Velocity Does Not Improve Prostate Cancer Detection

    Science.gov (United States)

    A rapid increase in prostate-specific antigen (PSA) levels is not grounds for automatically recommending a prostate biopsy, according to a study published online February 24, 2011, in the Journal of the National Cancer Institute.

  18. Advanced breast cancer rates in the epoch of service screening: The 400,000 women cohort study from Italy.

    Science.gov (United States)

    Puliti, Donella; Bucchi, Lauro; Mancini, Silvia; Paci, Eugenio; Baracco, Susanna; Campari, Cinzia; Canuti, Debora; Cirilli, Claudia; Collina, Natalina; Conti, Giovanni Maria; Di Felice, Enza; Falcini, Fabio; Michiara, Maria; Negri, Rossella; Ravaioli, Alessandra; Sassoli De' Bianchi, Priscilla; Serafini, Monica; Zorzi, Manuel; Caldarella, Adele; Cataliotti, Luigi; Zappa, Marco

    2017-04-01

    The objective of this study was to evaluate if mammography screening attendance is associated with a reduction in late-stage breast cancer incidence. The cohort included over 400,000 Italian women who were first invited to participate in regional screening programmes during the 1990s and were followed for breast cancer incidence for 13 years. We obtained individual data on their exposure to screening and correlated this with total and stage-specific breast cancer incidence. Socio-economic status and pre-screening incidence data were used to assess the presence of self-selection bias. Overall, screening attendance was associated with a 10% excess risk of in situ and invasive breast cancer (IRR = 1.10; 95% confidence interval (CI): 1.06-1.14), which dropped to 5% for invasive cancers only (IRR = 1.05; 95% CI: 1.01-1.09). There were significant reductions among attenders for specific cancer stages; we observed a 39% reduction for T2 or larger (IRR = 0.61; 95% CI: 0.57-0.66), 19% for node positives (IRR = 0.81; 95% CI: 0.76-0.86) and 28% for stage II and higher (IRR = 0.72; 95% CI: 0.68-0.76). Our data suggest that the presence of self-selection bias is limited and, overall, invited women experienced a 17% reduction of advanced cancers compared with pre-screening rates. Comparing attenders' and non-attenders' stage-specific breast cancer incidence, we have estimated that screening attendance is associated with a reduction of nearly 30% for stages II+. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. PSA LEVEL 3 DAN IMPLEMENTASINYA PADA KAJIAN KESELAMATAN PWR

    Directory of Open Access Journals (Sweden)

    Pande Made Udiyani

    2015-03-01

    Full Text Available Kajian keselamatan PLTN menggunakan metodologi kajian probabilistik sangat penting selain kajian deterministik. Metodologi kajian menggunakan Probabilistic Safety Assessment (PSA Level 3 diperlukan terutama untuk estimasi kecelakaan parah atau kecelakaan luar dasar desain PLTN. Metode ini banyak dilakukan setelah kejadian kecelakaan Fukushima. Dalam penelitian ini dilakukan implementasi PSA Level 3 pada kajian keselamatan PWR, postulasi kecelakan luar dasar desain PWR AP-1000 dan disimulasikan di contoh tapak Bangka Barat. Rangkaian perhitungan yang dilakukan adalah: menghitung suku sumber dari kegagalan teras yang terjadi, pemodelan kondisi meteorologi tapak dan lingkungan, pemodelan jalur paparan, analisis dispersi radionuklida dan transportasi fenomena di lingkungan, analisis deposisi radionuklida, analisis dosis radiasi, analisis perlindungan & mitigasi, dan analisis risiko. Kajian menggunakan rangkaian subsistem pada perangkat lunak PC Cosyma. Hasil penelitian membuktikan bahwa implementasi metode kajian keselamatan PSA Level 3 sangat efektif dan komprehensif terhadap estimasi dampak, konsekuensi, risiko, kesiapsiagaan kedaruratan nuklir (nuclear emergency preparedness, dan manajemen kecelakaan reaktor terutama untuk kecelakaan parah atau kecelakaan luar dasar desain PLTN. Hasil kajian dapat digunakan sebagai umpan balik untuk kajian keselamatan PSA Level 1 dan PSA Level 2. Kata kunci: PSA level 3, kecelakaan, PWR   Reactor safety assessment of nuclear power plants using probabilistic assessment methodology is most important in addition to the deterministic assessment. The methodology of Level 3 Probabilistic Safety Assessment (PSA is especially required to estimate severe accident or beyond design basis accidents of nuclear power plants. This method is carried out after the Fukushima accident. In this research, the postulations beyond design basis accidentsof PWR AP - 1000 would be taken, and simulated at West Bangka sample site. The

  20. Child Injury: What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-04-16

    This 60 second PSA is based on the April 2012 CDC Vital Signs report. Many childhood deaths and injuries are preventable, including those caused by crashes, suffocation, poisoning, drowning, fires, and falls. The PSA discusses ways to help prevent these deaths and injuries.  Created: 4/16/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/16/2012.

  1. THE DISCRIMINATIVE ABILITY OF PERCENT FREE PSA IN ...

    African Journals Online (AJOL)

    Objective To study the discriminative role of % free PSA in patients with a total PSA > 10 ng/ml. Patients and Methods Our patient cohort con-sisted of 90 males aged between 45 and 81 years (mean age: 67 ± 9 years). All patients had a biopsy-proven prostate pathology. Fifty-six patients had BPH (Group I) while 34 had ...

  2. Review of APR+ Level 2 PSA. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Lehner, John R. [Brookhaven National Lab. (BNL), Upton, NY (United States); Mubayi, Vinod [Brookhaven National Lab. (BNL), Upton, NY (United States); Pratt, W. Trevor [Brookhaven National Lab. (BNL), Upton, NY (United States); Kim, Do Sam [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Cho, Yong Jin [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Cho, Sang Jin [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of); Kim, In Goo [Korea Institute of Nuclear Safety (KINS), Daejeon (Korea, Republic of)

    2012-02-17

    Brookhaven National Laboratory (BNL) assisted the Korea Institute of Nuclear Safety (KINS) in reviewing the Level 2 Probabilistic Safety Assessment (PSA) of the APR+ Advanced Pressurized Water Reactor (PWR) prepared by the Korea Hydro & Nuclear Power Co., Ltd (KHNP) and KEPCO Engineering & Construction Co., Inc. (KEPCO-E&C). The work described in this report involves a review of the APR+ Level 2 PSA submittal [Ref. 1]. The PSA and, therefore, the review is limited to consideration of accidents initiated by internal events. As part of the review process, the review team also developed three sets of Requests for Additional Information (RAIs). These RAIs were provided to KHNP and KEPCO-E&C for their evaluation and response. This final detailed report documents the review findings for each technical element of the PSA and includes consideration of all of the RAIs made by the reviewers as well as the associated responses. This final report was preceded by an interim report [Ref. 2] that focused on identifying important issues regarding the PSA. In addition, a final meeting on the project was held at BNL on November 21-22, 2011, where BNL and KINS reviewers discussed their preliminary review findings with KHNP and KEPCO-E&C staffs. Additional information obtained during this final meeting was also used to inform the review findings of this final report. The review focused not only on the robustness of the APR+ design to withstand severe accidents, but also on the capability and acceptability of the Level 2 PSA in terms of level of detail and completeness. The Korean nuclear regulatory authorities will decide whether the PSA is acceptable and the BNL review team is providing its comments for KINS consideration. Section 2.0 provides the basis for the BNL review. Section 3.0 presents the review of each technical element of the PSA. Conclusions and a summary are presented in Section 4.0. Section 5.0 contains the references.

  3. Strong screening by lattice confinement and resultant fusion reaction rates in fcc metals

    Science.gov (United States)

    Prados-Estévez, F. M.; Subashiev, A. V.; Nee, H. H.

    2017-09-01

    The effects of electronic screening on the cross sections and reactivities for the nuclear reactions between light nuclei in Pd and Ni is studied. We consider the applicability of the theory of thermonuclear burning in stars to the D-D nuclear reaction in metals. The screening model based on the mean field potential of the electron cloud in the metal plasma is used. We discuss the specifics of the screening for the H (D) atoms embedded in vacancies and divacancies. High concentration of hydrogen isotopes segregated to monovacancies and divacancies in face-centered cubic (fcc) metals such as Ni and Pd with densities of ∼ 6 ×1023atom /cm3 , makes the hydrogen cluster a favorable active site for the fusion reaction. Still the observation of a nuclear reaction requires an accumulation of energy in D nuclei of at least several eV, which is far above what can be achieved in the thermal heating experiments.

  4. Active Choice and Financial Incentives to Increase Rates of Screening Colonoscopy-A Randomized Controlled Trial.

    Science.gov (United States)

    Mehta, Shivan J; Feingold, Jordyn; Vandertuyn, Matthew; Niewood, Tess; Cox, Catherine; Doubeni, Chyke A; Volpp, Kevin G; Asch, David A

    2017-11-01

    Behavioral economic approaches could increase uptake for colorectal cancer screening. We performed a randomized controlled trial of 2245 employees to determine whether an email containing a phone number for scheduling (control), an email with the active choice to opt in or opt out (active choice), or the active choice email plus a $100 incentive (financial incentive) increased colonoscopy completion within 3 months. Higher proportions of participants in the financial incentive group underwent screening (3.7%) than in the control (1.6%) or active choice groups (1.5%) (P = .01 and P < .01). We found no difference in uptake of screening between the active choice and control groups (P = .88). The $100 conditional incentive modestly but significantly increased colonoscopy use. ClinicalTrials.gov no: NCT02660671. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  5. Long-Term Trial Results Show No Mortality Benefit from Annual Prostate Cancer Screening

    Science.gov (United States)

    Thirteen year follow-up data from the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial show higher incidence but similar mortality among men screened annually with the prostate-specific antigen (PSA) test and digital rectal examination

  6. Overdetection, overtreatment and costs in prostate-specific antigen screening for prostate cancer

    NARCIS (Netherlands)

    E.A.M. Heijnsdijk (Eveline); A. der Kinderen (Arno); E.M. Wever (Elisabeth); G. Draisma (Gerrit); M.J. Roobol-Bouts (Monique); H.J. de Koning (Harry)

    2009-01-01

    textabstractBackground:Prostate cancer screening with prostate-specific antigen (PSA) has shown to reduce prostate cancer mortality in the European Randomised study of Screening for Prostate Cancer (ERSPC) trial. Overdetection and overtreatment are substantial unfavourable side effects with

  7. Incidence of histological prostatitis and its correlation with PSA density

    Directory of Open Access Journals (Sweden)

    Affonso Celso Piovesan

    2009-11-01

    Full Text Available OBJECTIVE: The aim of this study was to determine the incidence of asymptomatic, histologically proven prostatitis in men with symptoms of benign prostate hyperplasia and to observe the correlation between asymptomatic prostatitis and prostate specific antigen (PSA density. INTRODUCTION: The incidence of type IV prostatitis is unknown. There is a tendency to correlate the presence of inflammatory prostatitis with an elevation of PSA. MATERIALS AND METHODS: From August 2000 to January 2006, 183 patients who underwent surgical treatment for benign prostate hyperplasia as a result of obstructive or irritative symptoms were prospectively studied. In accordance with the histology findings, these patients were divided into two groups: group I included patients with the presence of histological prostatitis and group II included patients with the absence of histological prostatitis. The mean PSA densities were compared. RESULTS: Histological evidence of prostatitis was observed in 145 patients. In this group, the mean PSA density was 0.136 ± 0.095. In 38 cases, there was no evidence of inflammation upon histological examination of the surgical samples. In these 38 cases, the mean PSA density was 0.126 ± 0.129. No statistically significant differences were detected between the two groups; the p-value is 0.124. CONCLUSION: Abnormal PSA density should not be attributed to the inflammatory prostatitis process.

  8. A case of metastatic cancer with markedly elevated PSA level that was not detected by repeat prostate biopsy.

    Science.gov (United States)

    Iwamura, Hiromichi; Hatakeyama, Shingo; Tanaka, Yoshimi; Tanaka, Toshikazu; Tokui, Noriko; Yamamoto, Hayato; Imai, Atsushi; Yoneyama, Takahiro; Hashimoto, Yasuhiro; Koie, Takuya; Yoshikawa, Kazuaki; Ohyama, Chikara

    2014-01-29

    Prostate-specific antigen (PSA) is a widely used specific tumor marker for prostate cancer. We experienced a case of metastatic prostate cancer that was difficult to detect by repeat prostate biopsy despite a markedly elevated serum PSA level. A 64-year-old man was referred to our hospital with lumbar back pain and an elevated serum PSA level of 2036 ng/mL. Computed tomography, bone scintigraphy, and magnetic resonance imaging showed systemic lymph node and osteoblastic bone metastases. Digital rectal examination revealed a small, soft prostate without nodules. Ten-core transrectal prostate biopsy yielded negative results. Androgen deprivation therapy (ADT) was started because of the patient's severe symptoms. Twelve-core repeat transrectal prostate biopsy performed 2 months later, and transurethral resection biopsy performed 5 months later, both yielded negative results. The patient refused further cancer screening because ADT effectively relieved his symptoms. His PSA level initially decreased to 4.8 ng/mL, but he developed castration-resistant prostate cancer 7 months after starting ADT. He died 21 months after the initial prostate biopsy from disseminated intravascular coagulation. CUP remains a considerable challenge in clinical oncology. Biopsies of metastatic lesions and multimodal approaches were helpful in this case.

  9. Retrospective observation on contribution and limitations of screening for breast cancer with mammography in Korea: detection rate of breast cancer and incidence rate of interval cancer of the breast

    OpenAIRE

    Lee, Kunsei; Kim, Hyeongsu; Lee, Jung Hyun; Jeong, Hyoseon; Shin, Soon Ae; Han, Taehwa; Seo, Young Lan; Yoo, Youngbum; Nam, Sang Eun; Park, Jong Heon; Park, Yoo Mi

    2016-01-01

    Background The purpose of this study was to determine the benefits and limitations of screening for breast cancer using mammography. Methods Descriptive design with follow-up was used in the study. Data from breast cancer screening and health insurance claim data were used. The study population consisted of all participants in breast cancer screening from 2009 to 2014. Crude detection rate, positive predictive value and sensitivity and specificity of breast cancer screening and, incidence rat...

  10. The influence of prenatal screening and termination of pregnancy on perinatal mortality rates

    NARCIS (Netherlands)

    Pal-de Bruin, K.M. van der; Graafmans, W.; Biermans, M.C.J.; Richardus, J.H.; Zijlstra, A.G.; Reefhuis, J.; Mackenbach, J.P.; Verloove-Vanhorick, S.P.

    2002-01-01

    Objectives This study concerns the possible effect of practice of prenatal screening of congenital anomalies followed by termination of pregnancy on the perinatal mortality between European countries. Methods Data of nine region-specific EUROCAT registries from five European countries were used to

  11. Hearing screening follow-up return rate in a very low birth weight ...

    African Journals Online (AJOL)

    hearing and 7 to have unilateral normal hearing. The 27 VLBW neonates who attended the follow-up screening presented with one or more risk factors for hearing loss. All but. 1 were preterm and had neonatal jaundice, 5 were in the NICU for more than 48 hours, and 4 were on mechanical ventilation. With regard to HIV, ...

  12. ADAM 12 may be used to reduce the false positive rate of first trimester combined screening for Down syndrome

    DEFF Research Database (Denmark)

    Christiansen, Michael; Pihl, Kasper; Hedley, Paula L.

    2010-01-01

    % to 89% for a false positive rate (FPR) of 5%. When used for a fixed DR of 90%, the addition of ADAM12 resulted in a 25% reduction of the FPR. CONCLUSION: ADAM12 is a moderately effective DS marker. It is not a cost-effective addition to CUB screening, but may be used to reduce the FPR in selected high......: ADAM12 concentrations were determined in 28 first trimester DS and 503 control pregnancies using a novel Research Delfia ADAM12 kit. Log10MoM distributions of ADAM12 and correlations with other markers were established. Population performance of screening was estimated by Monte Carlo simulation....... RESULTS: ADAM12 was significantly reduced in the first trimester in DS pregnancies with a log10MoM of -0.1621 (equivalent to 0.68 MoM) (p rate (DR) from 86...

  13. 11C–Choline PET / CT in the detection of prostate cancer relapse in patients with rising PSA

    Directory of Open Access Journals (Sweden)

    I. P. Aslanidis

    2015-01-01

    Full Text Available Objective. To evaluate the diagnostic impact of 11C–Choline PET / CT in the detection of recurrent prostate cancer (PCa in patients with biochemical relapse after radical prostatectomy and to assess the correlation between PSA levels and PET / CT detection rate of PCa relapse.Subjects and methods. 85 patients with biochemical relapse (mean PSA 3.51 ± 3.87 ng / ml after radical prostatectomy (n = 64 and radiotherapy (n = 21 underwent 11C–Choline PET / CT. According to PSA level, patients were divided into three groups:  2 ng / ml, 2 to 9 ng / ml and > 9 ng / ml.Results. Overall, 11C–Choline PET / CT detected PCa relapse in 33 of 85 patients (39 %. The mean PSA value in PET-positive patients was 5.78 ± 4.95 (0.22–17.80 ng / ml, while in PET-negative patients – 1.43 ± 1.08 (0.28–4.57 ng / ml. Positive PET / CT results were obtained in 9 of 40 patients (22 % with PSA of < 2 ng / ml, in 17 of 38 patients (45 % with PSA of 2 to 9 ng / ml, and in 7 of 7 patients (100 % with PSA of > 9 ng / ml. Local relapse was detected in 42 % (14 / 33 patients. Both local and distant metastases were diagnosed in 39 % (13 / 33 cases. Distant relapsewas identified in 19 % (6 / 33 cases. PET / CT allowed to assess the efficacy of treatment in 26 % (12 / 47 PET-negative patients under hormone therapy at the scan time. However, PET / CT wasn’t able to localize the site of PCa recurrence in these hormone-ensitive patients what might have affected the overall detection rate.Conclusion. 1 11C–Choline PET / CT was able to detect and correctly identify the site of PCa relapse in 39 % cases and therefore was useful in determining the further therapeutic approach. 2 Our data confirmed the strong correlation between PSA levels and 11C–Choline PET / CT detection rate of PCa relapse (r = 0.9; p < 0.001. 3 11C–Choline PET / CT has limited utility in localizing the site of PCa recurrence in some patients under hormone therapy.

  14. Prostate-specific antigen: does the current evidence support its use in prostate cancer screening?

    LENUS (Irish Health Repository)

    Duffy, Michael J

    2012-02-01

    Although widely used, the value of prostate-specific antigen (PSA) in screening asymptomatic men for prostate cancer is controversial. Reasons for the controversy relate to PSA being less than an ideal marker in detecting early prostate cancer, the possibility that screening for prostate cancer may result in the overdetection and thus overtreatment of indolent disease and the lack of clarity as to the definitive or best treatment for men diagnosed with localized prostate cancer. Although the results from some randomized prospective trials suggest that screening with PSA reduces mortality from prostate cancer, the overall benefit was modest. It is thus currently unclear as to whether the modest benefit of reduced mortality outweighs the harms of overdetection and overtreatment. Thus, prior to undergoing screening for prostate cancer, men should be informed of the risks and benefits of early detection. Newly emerging markers that may complement PSA in the early detection of prostate cancer include specific isoforms of PSA and PCA3.

  15. Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial.

    Science.gov (United States)

    Eichler, Tilly; Thyrian, Jochen René; Hertel, Johannes; Köhler, Leonore; Wucherer, Diana; Dreier, Adina; Michalowsky, Bernhard; Teipel, Stefan; Hoffmann, Wolfgang

    2014-01-01

    Primary data about rates of formal diagnosis of dementia in the German primary care sector are widely lacking. Main objectives are to analyze the rate of syndrome diagnosis in primary care patients who screened positive for dementia, the distribution of differential diagnoses, and factors associated with undiagnosed dementia. DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is an ongoing general practitioner (GP)-based, randomized, controlled intervention trial. A total of 4,064 patients (≥70 years, living at home) recruited from 108 participating GP practices were screened for dementia (DemTect informed consent. Present analyses are based on the data of 243 patients with complete baseline assessment on January 1, 2014 (preliminary data). Formal diagnoses were retrieved from the medical records of the treating GPs. A conditional fixed effect regression analysis was performed to analyze factors associated with undiagnosed dementia. A total of 40% of patients who screened positive for dementia had been formally diagnosed with dementia. Unspecified dementia was diagnosed in 53%, vascular dementia in 24%, and Alzheimer's disease in 19% of these patients. Undiagnosed dementia was significantly associated with a higher mean score in the Mini-Mental State Examination (odds ratio, 1.11; p dementia in German primary care (40%) is well within the range of the international data (20-50%). The results emphasize the need for action to enhance recognition and differential diagnosis of dementia.

  16. Analysis of Current DNA Encoded Library Screening Data Indicates Higher False Negative Rates for Numerically Larger Libraries.

    Science.gov (United States)

    Satz, Alexander L; Hochstrasser, Remo; Petersen, Ann C

    2017-04-10

    To optimize future DNA-encoded library design, we have attempted to quantify the library size at which the signal becomes undetectable. To accomplish this we (i) have calculated that percent yields of individual library members following a screen range from 0.002 to 1%, (ii) extrapolated that ∼1 million copies per library member are required at the outset of a screen, and (iii) from this extrapolation predict that false negative rates will begin to outweigh the benefit of increased diversity at library sizes >10 8 . The above analysis is based upon a large internal data set comprising multiple screens, targets, and libraries; we also augmented our internal data with all currently available literature data. In theory, high false negative rates may be overcome by employing larger amounts of library; however, we argue that using more than currently reported amounts of library (≫10 nmoles) is impractical. The above conclusions may be generally applicable to other DNA encoded library platforms, particularly those platforms that do not allow for library amplification.

  17. Comparison of SKIFS 2004:1 and Tillsynshandbok PSA against the ASME PRA Standard and European requirements on PSA; Jaemfoerelse av SKIFS 2004:1 och Tillsynshandbok PSA mot ASME PRA Standard och Europeiska krav paa PSA

    Energy Technology Data Exchange (ETDEWEB)

    Hellstroem, Per

    2005-04-15

    Requirements on PSA for risk informed applications are expressed in different international documents. The ASME PRA standard published in spring 2002 is one such document, PSA requirements are also expressed in the European Utility Requirements (EUR) for new reactors. The Swedish PSA requirements are provided in the Swedish regulators (SKI) statutes SKIFS 2004:1. SKI also has a review handbook for PSA activities (SKI report 2003:48). The review handbook is a support during review of the utilities PSA activities and the PSAs themselves. The review handbook expresses SKIs expectations by providing so called important aspects for both the PSA work and the PSAs, A comparison of SKIFS requirements and the important aspects in the Review handbook, on one side, and the requirements on PSA in EUR and ASME on the other side, is presented. The comparison shows a large difference in the level of detail in the different documents, where ASME is most detailed and specific. This is expected since the SKI review handbook not is a 'PSA guide' in the same way as the ASME PRA standard. A direct comparison of the ASME PRA standard requirements with the important aspects in the review handbook cannot answer the question which ASME capacity level that is achieved by a PSA meeting all important aspects. The conclusion is that it is not likely to achieve capacity level 2 and 3, since very few ASME level 3 attributes are explicitly expressed as important aspects, though many are expressed in general terms. The review handbook important aspects that are most similar to the ASME capacity level 1 attributes are initiating events, sequence analysis, and system analysis while less similarity is found for analysis of operator actions data analysis, quantification and containment analysis (level 2). Less similarity is found for capacity level 2 and 3. However, the number of additional ASME attributes on capacity level 2 and 3 are few. There are also important aspects in the review

  18. Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates.

    Science.gov (United States)

    Kaczorowski, Janusz; Hearps, Stephen J C; Lohfeld, Lynne; Goeree, Ron; Donald, Faith; Burgess, Ken; Sebaldt, Rolf J

    2013-06-01

    To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs). Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system. Southwestern Ontario. A total of 232 physicians from 24 primary care network or family health network groups across 110 different sites eligible for pay-for-performance incentives. The P-PROMPT project combined pay-for-performance incentives with provider and patient reminders and deployment of NPs to enhance the delivery of preventive care services. The mean delivery rates at the practice level of time-appropriate mammograms and Papanicolaou tests completed within the previous 30 months. Before-and-after comparisons of time-appropriate delivery rates (performance incentives resulted in increases in the uptake of Pap tests and mammograms among eligible primary care patients over a 1-year period in family practices in Ontario.

  19. Breast Cancer Detected at Screening US: Survival Rates and Clinical-Pathologic and Imaging Factors Associated with Recurrence.

    Science.gov (United States)

    Kim, Soo-Yeon; Han, Boo-Kyung; Kim, Eun-Kyung; Choi, Woo Jung; Choi, Yunhee; Kim, Hak Hee; Moon, Woo Kyung

    2017-08-01

    Purpose To determine the survival rates and clinical-pathologic and imaging factors associated with recurrence in women with breast cancer detected at screening ultrasonography (US). Materials and Methods This study was approved by the institutional review board, and the requirement to obtain informed consent was waived. A retrospective review of the databases of four institutions identified 501 women (median age, 47 years; range, 27-74 years) with breast cancer (425 invasive cancers and 76 ductal carcinoma in situ) detected at screening US between January 2004 and March 2011. Five-year overall survival (OS) and recurrence-free survival (RFS) rates were estimated, and the clinical-pathologic and imaging data were collected. Multivariate analysis was performed by using Cox proportional hazard regression to determine factors associated with recurrence. Results At a median follow-up of 7.0 years (range, 5.0-12.1 years), 15 (3.0%) recurrences were detected: five in ipsilateral breast and 10 in contralateral breast. The 5-year OS and RFS rates were 100% and 98.0% (95% confidence interval [CI]: 96.8%, 99.2%), respectively. In patients with invasive cancers, age younger than 40 years (hazard ratio: 3.632 [95% CI: 1.099, 11.998]; P = .032), the triple-negative subtype (hazard ratio: 7.498 [95% CI: 2.266, 24.816]; P = .001), and Breast Imaging Reporting and Data System (BI-RADS) category 4A lesions (hazard ratio: 5.113 [95% CI: 1.532, 17.195]; P = .008) were associated with recurrence. Conclusion Women with breast cancers detected at screening US have excellent outcomes, with a 5-year RFS rate of 98.0%. However, in patients with invasive breast cancer, age younger than 40 years, the triple-negative subtype, and BI-RADS category 4A lesions were associated with recurrence. © RSNA, 2017 Online supplemental material is available for this article.

  20. Decreased fucosylated PSA as a urinary marker for high Gleason score prostate cancer.

    Science.gov (United States)

    Fujita, Kazutoshi; Hayashi, Takuji; Matsuzaki, Kyosuke; Nakata, Wataru; Masuda, Mika; Kawashima, Atsunari; Ujike, Takeshi; Nagahara, Akira; Tsuchiya, Mutsumi; Kobayashi, Yuka; Nojima, Satoshi; Uemura, Motohide; Morii, Eiichi; Miyoshi, Eiji; Nonomura, Norio

    2016-08-30

    Fucosylation is an important oligosaccharide modification associated with cancer and inflammation. We investigated whether urinary fucosylated PSA (Fuc-PSA) levels could be used for the detection of high Gleason score prostate cancer. Urine samples were collected from men with abnormal digital rectal examination findings or elevated serum PSA levels, before prostate biopsy. Lectin-antibody ELISA was used to quantify the Lewis-type or core-type fucosylated PSA (PSA-AAL) and core-type fucosylated PSA (PSA-PhoSL) in the urine samples. Both types of urinary Fuc-PSA were significantly decreased in the men with prostate cancer compared with the men whose biopsies were negative for cancer (P = 0.026 and P Gleason scores of the biopsy specimens (P = 0.001 and P Gleason score prostate cancer. The area under the receiver-operator characteristic curve (AUC) value for the prediction of cancers of Gleason score ≥ 7 was 0.69 for urinary PSA-AAL and 0.72 for urinary PSA-PhoSL. In contrast, the AUC value was 0.59 for serum PSA, 0.63 for PSA density, and 0.58 for urinary PSA. In conclusion, a decreased urinary Fuc-PSA level is a potential marker for the detection of high Gleason score prostate cancer.

  1. High-Risk Prostate Cancer With Gleason Score 8-10 and PSA Level {<=}15 ng/ mL Treated With Permanent Interstitial Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Fang, L. Christine [Department of Radiation Oncology, University of Washington, Seattle, WA (United States); Merrick, Gregory S., E-mail: gmerrick@urologicresearchinstitute.org [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, WV (United States); Butler, Wayne M.; Galbreath, Robert W.; Murray, Brian C.; Reed, Joshua L. [Schiffler Cancer Center, Wheeling Jesuit University, Wheeling, WV (United States); Adamovich, Edward [Department of Pathology, Wheeling Hospital, Wheeling, WV (United States); Wallner, Kent E. [Puget Sound Veterans Affairs Hospital, Seattle, WA (United States)

    2011-11-15

    Purpose: With widespread prostate-specific antigen (PSA) screening, there has been an increase in men diagnosed with high-risk prostate cancer defined by a Gleason score (GS) {>=}8 coupled with a relatively low PSA level. The optimal management of these patients has not been defined. Cause-specific survival (CSS), biochemical progression-free survival (bPFS), and overall survival (OS) were evaluated in brachytherapy patients with a GS {>=}8 and a PSA level {<=}15 ng/mL with or without androgen-deprivation therapy (ADT). Methods and Materials: From April 1995 to October 2005, 174 patients with GS {>=}8 and a PSA level {<=}15 ng/mL underwent permanent interstitial brachytherapy. Of the patients, 159 (91%) received supplemental external beam radiation, and 113 (64.9%) received ADT. The median follow-up was 6.6 years. The median postimplant Day 0 minimum percentage of the dose covering 90% of the target volume was 121.1% of prescription dose. Biochemical control was defined as a PSA level {<=}0.40 ng/mL after nadir. Multiple parameters were evaluated for impact on survival. Results: Ten-year outcomes for patients without and with ADT were 95.2% and 92.5%, respectively, for CSS (p = 0.562); 86.5% and 92.6%, respectively, for bPFS (p = 0.204); and 75.2% and 66.0%, respectively, for OS (p = 0.179). The median post-treatment PSA level for biochemically controlled patients was <0.02 ng/mL. Multivariate analysis failed to identify any predictors for CSS, whereas bPFS and OS were most closely related to patient age. Conclusions: Patients with GS {>=}8 and PSA level {<=}15 ng/mL have excellent bPFS and CSS after brachytherapy with supplemental external beam radiotherapy. The use of ADT did not significantly impact bPFS, CSS, or OS.

  2. Physiotherapist agreement when visually rating movement quality during lower extremity functional screening tests.

    Science.gov (United States)

    Whatman, Chris; Hing, Wayne; Hume, Patria

    2012-05-01

    To investigate physiotherapist agreement in rating movement quality during lower extremity functional tests using two visual rating methods and physiotherapists with differing clinical experience. Clinical measurement. Six healthy individuals were rated by 44 physiotherapists. These raters were in three groups (inexperienced, novice, experienced). Video recordings of all six individuals performing four lower extremity functional tests were visually rated (dichotomous or ordinal scale) using two rating methods (overall or segment) on two occasions separated by 3-4 weeks. Intra and inter-rater agreement for physiotherapists was determined using overall percentage agreement (OPA) and the first order agreement coefficient (AC1). Intra-rater agreement for overall and segment methods ranged from slight to almost perfect (OPA: 29-96%, AC1: 0.01 to 0.96). AC1 agreement was better in the experienced group (84-99% likelihood) and for dichotomous rating (97-100% likelihood). Inter-rater agreement ranged from fair to good (OPA: 45-79%; AC1: 0.22-0.71). AC1 agreement was not influenced by clinical experience but was again better using dichotomous rating. Physiotherapists' visual rating of movement quality during lower extremity functional tests resulted in slight to almost perfect intra-rater agreement and fair to good inter-rater agreement. Agreement improved with increased level of clinical experience and use of dichotomous rating. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. New endoscopy advances to refine adenoma detection rate for colorectal cancer screening: None is the winner.

    Science.gov (United States)

    Maida, Marcello; Camilleri, Salvatore; Manganaro, Michele; Garufi, Serena; Scarpulla, Giuseppe

    2017-10-15

    Colorectal cancer (CRC) is the third most common cancer in males and second in females, and globally the fourth cause for cancer death worldwide. Oncological screening of CRC has a major role in the management of the disease and it is mostly performed by colonoscopy. Anyway, effectiveness of endoscopic screening for CRC strictly depends on adequate detection and removal of potentially precancerous lesions, and accuracy of colonoscopy in detection of adenomas is still suboptimal. For this reason, several technological advances have been implemented in order to improve the diagnostic sensitivity of colonoscopy in adenoma detection. Among these: (1) Visual technologies such as chromoendoscopy and narrow band imaging; (2) optical innovation as high definition endoscopy, full-spectrum endoscopy or Third Eye Retroscope; and (3) mechanical advances as Cap assisted colonoscopy, Endocuff, Endoring and G-Eye endoscope. All these technologies advances have been tested over time by clinical studies with mixed results. Which of them is more likely to be successful in the next future?

  4. Differences in preventive screening rates in Wisconsin farm and non-farm resident women.

    Science.gov (United States)

    McCarty, Catherine A; Chyou, Po-Huang; Greenlee, Robert; McCarty, Daniel J; Gunderson, Paul; Reding, Douglas

    2003-01-01

    To determine the proportion of rural women who met screening recommendations for Pap smears, mammograms, blood cholesterol, and blood pressure measurements. Women aged 25-75 were recruited for a population-based study of chronic diseases in rural residents. In addition to a self-administered health questionnaire and a brief examination, the most recent Pap smear, mammogram, blood pressure, and blood cholesterol measurements were documented from electronic medical records. The study population was comprised of 675 farm and 825 non-farm residents. Fifty-five women (3.7%) had no documentation in their medical records of having ever had a Pap smear, and 19.3% (95% CL 16.9, 21.7) of women aged 40 and older had no documentation of a mammogram. Ninety-two percent of the women (95% CL = 90.2, 93.7) had a blood pressure measurement in the previous 2 years and 74.9% (95% CL = 72.2, 77.6) had a blood cholesterol measurement in the previous 5 years. Age was inversely related to Pap smears and positively correlated with mammograms, blood pressure, and blood cholesterol measurements. Farm residents were significantly less likely to have Pap smears or blood pressure measurements at recommended time intervals. To increase the proportion of rural women in compliance with preventive screening recommendations, public health education efforts should target farm residents and younger women.

  5. A simple computer program for calculating PSA recurrence in prostate cancer patients

    Directory of Open Access Journals (Sweden)

    Liao Zhongyue

    2004-06-01

    Full Text Available Abstract Background Prostate cancer is the most common tumor in men. The most commonly used diagnostic and tumor recurrence marker is Prostate Specific Antigen (PSA. After surgical removal or radiation treatment, PSA levels drop (PSA nadir and subsequent elevated or increased PSA levels are indicative of recurrent disease (PSA recurrence. For clinical follow-up and local care PSA nadir and recurrence is often hand calculated for patients, which can result in the application of heterogeneous criteria. For large datasets of prostate cancer patients used in clinical studies PSA measurements are used as surrogate measures of disease progression. In these datasets a method to measure PSA recurrence is needed for the subsequent analysis of outcomes data and as such need to be applied in a uniform and reproducible manner. This method needs to be simple and reproducible, and based on known aspects of PSA biology. Methods We have created a simple Perl-based algorithm for the calculation of post-treatment PSA outcomes results based on the initial PSA and multiple PSA values obtained after treatment. The algorithm tracks the post-surgical PSA nadir and if present, subsequent PSA recurrence. Times to PSA recurrence or recurrence free intervals are supplied in months. Results Use of the algorithm is demonstrated with a sample dataset from prostate cancer patients. The results are compared with hand-annotated PSA recurrence analysis. The strengths and limitations are discussed. Conclusions The use of this simple PSA algorithm allows for the standardized analysis of PSA recurrence in large datasets of patients who have undergone treatment for prostate cancer. The script is freely available, and easily modifiable for desired user parameters and improvements.

  6. Simulation and optimization of an industrial PSA unit

    Directory of Open Access Journals (Sweden)

    Barg C.

    2000-01-01

    Full Text Available The Pressure Swing Adsorption (PSA units have been used as a low cost alternative to the usual gas separation processes. Its largest commercial application is for hydrogen purification systems. Several studies have been made about the simulation of pressure swing adsorption units, but there are only few reports on the optimization of such processes. The objective of this study is to simulate and optimize an industrial PSA unit for hydrogen purification. This unit consists of six beds, each of them have three layers of different kinds of adsorbents. The main impurities are methane, carbon monoxide and sulfidric gas. The product stream has 99.99% purity in hydrogen, and the recovery is around 90%. A mathematical model for a commercial PSA unit is developed. The cycle time and the pressure swing steps are optimized. All the features concerning with complex commercial processes are considered.

  7. THE EFFECTS OF STORAGE TEMPERATURE AND TYPES OF MEDIA ON THE SURVIVAL RATE OF S. agalactiae BACTERIOPHAGE

    Directory of Open Access Journals (Sweden)

    Angela Mariana Lusiastuti

    2008-12-01

    Full Text Available The successful effect of phages in phage therapy has been proven by an increase of the presence of phages in survivors. Seven previously isolated phages were used to examine the effects of storage temperature and types of media on their survival rate. Phages PSaT-18, PSaT-19, PSaT-20 and PSaT-21 isolated from a Streptococcosis-infected Tilapia (Oreochromis niloticus were used in this study. Phages PSaG-1, PSaG-2 and PSaG-3 were isolated from a diseased Gouramy (Osphronemus gouramy. All of the phages were stored in refrigerator at temperature of 8oC and kept in two types of media, Brain Heart Infusion Broth (BHIB and BHIB enriched with glycerol. To determine the lytic activity of the phages, 20 μL of each phage suspension was poured onto BHIA plate and incubated at 25oC for 24 to 48 hours. The result showed that phages PSaT-18, PSaT-19, PSaT-20 and PSaT-21 have lytic activity against S. agalactiae and S. iniae than phages PSaG-1, PSaG-2, and PSaG-3. Phages PSaT-18, PSaT-19, PSaT-20, and PSaT-21 always survived up to three weeks and phage PSaT-18 in BHIB have the highest potential as a candidate of phage therapy for Streptococcosis.

  8. Aneuploidy screening by array comparative genomic hybridization improves success rates of in vitro fertilization: A multicenter Indian study

    Directory of Open Access Journals (Sweden)

    Aditi Kotdawala

    2016-01-01

    Full Text Available Objective: To evaluate the usefulness of preimplantation genetic screening (PGS using array comparative genomic hybridization (aCGH in the Indian population. Materials and Methods: This is a retrospective, multicenter study including 235 PGS cycles following intracytoplasmic sperm injection performed at six different infertility centers from September 2013 to June 2015. Patients were divided as per maternal age in several groups (40 years and as per indication for undergoing PGS. Indications for performing PGS were recurrent miscarriage, repetitive implantation failure, severe male factor, previous trisomic pregnancy, and advanced maternal age (≥35. Day 3 embryo biopsy was performed and analyzed by aCGH followed by day 5 embryo transfer in the same cycle or the following cycle. Outcomes such as pregnancy rates (PRs/transfer, implantation rates, miscarriage rates, percentage of abnormal embryos, and number of embryos with more than one aneuploidy and chaotic patterns were recorded for all the treated subjects based on different age and indication groups. Results: aCGH helped in identifying aneuploid embryos, thus leading to consistent implantation (range: 33.3%-42.9% and PRs per transfer (range: 31.8%-54.9% that were obtained for all the indications in all the age groups, after performing PGS. Conclusion: Aneuploidy is one of the major factors which affect embryo implantation. aCGH can be successfully employed for screening of aneuploid embryos. When euploid embryos are transferred, an increase in PRs can be achieved irrespective of the age or the indication.

  9. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009.

    Science.gov (United States)

    Chuck, Kumban Walter; Hwang, Minji; Choi, Kui Son; Suh, Mina; Jun, Jae Kwan; Park, Boyoung

    2017-01-01

    To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, pgastric cancer; 60.5 vs. 71.5%, pcancer; and 49.1 vs. 59.6%, pcancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, pcancer (38.8 vs. 44.6%, pcancer (35.1 vs. 51.2%, pscreening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9). The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  10. Analysis of monotherapy prostate brachytherapy in patients with prostate cancer. Initial PSA and Gleason are important for recurrence?

    Directory of Open Access Journals (Sweden)

    Pedro Galego

    2015-04-01

    Full Text Available Purpose To evaluate the clinical outcome of a cohort of localized prostate cancer patients treate with 125-I permanent brachytherapy at the São José Hospital – CHLC, Lisbon. Materials and Methods A retrospective analysis was carried out on 429 patients with low and intermediate-risk of prostate adenocarcinoma, according to the recommendations of the EORTC, who underwent 125I brachytherapies in intraoperative dosimetry “real-time” system between September 2003 and September 2013. Results The mean follow-up was 71.98 months. Biochemical relapse of disease by rising PSA (Phoenix criterion was observed in 18 patients (4.2%. Through the application of Kaplan-Meier survival curves in this sample, the rate of survival at 6 years without biochemical relapse was higher than 95%. By Iog rank test comparing biochemical relapse with initial PSA (15-10 and <10 and Gleason values (7 and <7, there was no statistical difference (P=0.830 of the initial PSA in the probability of developing biochemical relapse. In relation to Gleason score, it was noted a statistical difference (P<0.05, demonstrating that patients with Gleason 7 are more likely to develop biochemical relapse. Conclusions Brachytherapy as monotherapy is at present an effective choice in the treatment of localized prostate adenocarcinoma. Biochemical relapses are minimal. The initial PSA showed no statistically difference in the rate of relapses, unlike the value Gleason, where it was demonstrated that patients with Gleason 7 have a higher probability of biochemical relapse. Cases with PSA bounce should be controlled before starting a salvage treatment.

  11. Classification Accuracy and Acceptability of the Integrated Screening and Intervention System Teacher Rating Form

    Science.gov (United States)

    Daniels, Brian; Volpe, Robert J.; Fabiano, Gregory A.; Briesch, Amy M.

    2017-01-01

    This study examines the classification accuracy and teacher acceptability of a problem-focused screener for academic and disruptive behavior problems, which is directly linked to evidence-based intervention. Participants included 39 classroom teachers from 2 public school districts in the Northeastern United States. Teacher ratings were obtained…

  12. Reducing the Risk of Methadone Overdose PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-07-03

    This 60 second PSA is based on the July 2012 CDC Vital Signs report. Approximately 14 people die every day of overdoses related to methadone. Listen to learn how to reduce your risk of an overdose.  Created: 7/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 7/3/2012.

  13. Association between steroid hormone receptors and PSA gene ...

    African Journals Online (AJOL)

    associated with presence of steroid hormone receptors. The aim of this research was to show differential expression and association between steroid hormone receptors and PSA gene expression in breast cancer cell lines. The cell lines investigated were steroid receptor-negative breast carcinoma cell lines BT-20 and ...

  14. Asian and Pacific Islander HIV/AIDS Awareness PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-05-12

    In this PSA, Asians and Pacific Islanders are encouraged to talk about HIV and get tested for HIV.  Created: 5/12/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/12/2010.

  15. Hand Hygiene in Healthcare Settings 1 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-08-19

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.  Created: 8/19/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/19/2010.

  16. Hand Hygiene in Healthcare Settings 2 PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-08-19

    This 30 second PSA encourages people to wash their hands often while in the hospital or visiting someone in the hospital. It also encourages them to remind their healthcare providers to wash their hands, too.  Created: 8/19/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/19/2010.

  17. Lifestyle and Clinical Health Behaviors and PSA Tests

    Science.gov (United States)

    Norris, Cynthia; McFall, Stephanie

    2006-01-01

    This study assessed the association of lifestyle and clinical health behaviors with prostate specific antigen (PSA) tests. The study used cross-sectional data from the 2002 Behavioral Risk Factor Surveillance System (BRFSS). We used Stata 8.0 to take into account the complex sample design in analyses. Both lifestyle and clinical health behaviors…

  18. System analysis procedures for conducting PSA of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoon Hwan; Jeong, Won Dae; Kim, Tae Un; Kim, Kil You; Han, Sang Hoon; Chang, Seung Chul; Sung, Tae Yong; Yang, Jun Eon; Kang, Dae Il; Park, Jin Hee; Hwang, Mi Jeong; Jin, Young Ho

    1997-03-01

    This document, the Probabilistic Safety Assessment(PSA) procedures guide for system analysis, is intended to provide the guidelines to analyze the target of system consistently and technically in the performance of PSA for nuclear power plants(NPPs). The guide has been prepared in accordance with the procedures and techniques for fault tree analysis(FTA) used in system analysis. Normally the main objective of system analysis is to assess the reliability of system modeled by Event Tree Analysis(ETA). A variety of analytical techniques can be used for the system analysis, however, FTA method is used in this procedures guide. FTA is the method used for representing the failure logic of plant systems deductively using AND, OR or NOT gates. The fault tree should reflect all possible failure modes that may contribute to the system unavailability. This should include contributions due to the mechanical failures of the components, Common Cause Failures (CCFs), human errors and outages for testing and maintenance. After the construction of fault tree is completed, system unavailability is calculated with the CUT module of KIRAP, and the qualitative and quantitative analysis is performed through the process as above stated. As above mentioned, the procedures for system analysis is based on PSA procedures and methods which has been applied to the safety assessments of constructing NPPs in the country. Accordingly, the method of FTA stated in this procedures guide will be applicable to PSA for the NPPs to be constructed in the future. (author). 6 tabs., 11 figs., 7 refs.

  19. An empirical study of the 'underscreened' in organised cervical screening: experts focus on increasing opportunity as a way of reducing differences in screening rates.

    Science.gov (United States)

    Williams, Jane H; Carter, Stacy M

    2016-10-06

    Cervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status (SES). Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like 'equity'. Equity is a poorly defined and understood concept. We aimed to explain experts' perspectives on how cervical screening programs might justifiably respond to 'the underscreened'. This paper reports on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing. Most experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines. Experts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease

  20. Polyp detection rate and pathological features in patients undergoing a comprehensive colonoscopy screening

    Science.gov (United States)

    Asadzadeh Aghdaei, Hamid; Nazemalhosseini Mojarad, Ehsan; Ashtari, Sara; Pourhoseingholi, Mohmad Amin; Chaleshi, Vahid; Anaraki, Fakhrosadat; Haghazali, Mehrdad; Zali, Mohammad Reza

    2017-01-01

    AIM To identify the prevalence, and clinical and pathologic characteristic of colonic polyps among Iranian patients undergoing a comprehensive colonoscopy, and determine the polyp detection rate (PDR) and adenoma detection rate (ADR). METHODS In this cross-sectional study, demographics and epidemiologic characteristics of 531 persons who underwent colonoscopies between 2014 and 2015 at Mehrad gastrointestinal clinic were determined. Demographics, indication for colonoscopy, colonoscopy findings, number of polyps, and histopathological characteristics of the polyps were examined for each person. RESULTS Our sample included 295 (55.6%) women and 236 (44.4%) men, with a mean age of 50.25 ± 14.89 years. Overall PDR was 23.5% (125/531). ADR and colorectal cancer detection rate in this study were 12.8% and 1.5%, respectively. Polyps were detected more significantly frequently in men than in women (52.8% vs 47.2%, P Polyps can be seen in most patients after the age of 50. The average age of patients with cancer was significantly higher than that of patients with polyps (61.3 years vs 56.4 years, P polyps were adenomatous. More than 50% of the polyps were found in the rectosigmoid part of the colon. CONCLUSION The prevalence of polyps and adenomas in this study is less than that reported in the Western populations. In our patients, distal colon is more susceptible to developing polyps and cancer than proximal colon. PMID:28251034

  1. Methodological approaches to perform a site specific PSA on the effects of comprehensive events; Methodische Ansaetze zur Durchfuehrung einer standortspezifischen PSA zu den Auswirkungen uebergreifender Einwirkungen

    Energy Technology Data Exchange (ETDEWEB)

    Tuerschmann, Michael; Sperbeck, Silvio; Frey, Walter

    2016-12-15

    Main objective of the project 3612R01550 performed on behalf of the Federal Ministry for the Environment, Nature Conservation, Building and Nuclear Safety (BMUB) is the development of an approach for systematic consideration of dependencies in case of internal and external hazards and their combinations in the probabilistic plant model for nuclear power plants. One of the major aspects of a site specific Level 1 PSA carried out for a nuclear power plant outlined in this report is taking comprehensively into account the entire risks resulting from internal and external hazards. In a first step, all the hazards which may occur at the site under investigation have to be identified. This requires a compilation of the potential hazards and their possible combinations: Based on this compilation of generic hazards a site specific list of hazards to be considered in the analysis can be derived based on a screening process taking into account regulatory requirements and insights from site and plant walk-downs. In a second step, the hazards to be considered for the specific site have to be classified with respect to the depth of the probabilistic analyses to be carried out. This classification covers three categories: hazards with a negligible contribution to the overall risk, hazards with such a low risk contribution that a rough quantitative assessment is sufficient, and hazards which need in-depth probabilistic analysis. Based on the available Level 1 PSA model for internal events, a systematic approach for in-depth probabilistic analyses of hazards and their combinations is proposed. In this context, lists of those structures, systems and components, which can be impaired in their required function resulting in a risk increase, are provided. One of these lists contains the equipment, the other one the dependencies to be considered for the corresponding hazard. In addition to the general approach for performing site specific PSA, a procedure for modelling dependencies in

  2. A tool for rapid screening of direct DNA agents using reaction rates and relative interaction potency: towards screening environmental contaminants for hazard.

    Science.gov (United States)

    Gavina, Jennilee M A; Rubab, Mamoona; Zhang, Huijuan; Zhu, Jiping; Nong, Andy; Feng, Yong-Lai

    2011-11-01

    DNA damage represents a potential biomarker for determining the exposure risk to chemicals and may provide early warning data for identifying chemical hazards to human health. Here, we have demonstrated a simple chromatography-based method that can be used to rapidly screen for the presence of chemical hazards as well as to determine parameters relevant to hazard assessment. In this proof-of-principle study, a simple in vitro system was used to determine the interaction of pollutants and probable carcinogens, phenyl glycidyl ether (PGE), tetrachlorohydroquinone (Cl(4)HQ), methylmethane sulfonate (MMS), styrene-7,8-oxide (SO), and benzo[a]pyrene-7,8-dihydrodiol-9,10-epoxide (BPDE), a metabolite of benzo[a]pyrene (B[a]P), with single- and double-stranded DNA probes. Differences in potency and reaction kinetics were studied for chemical and DNA type. A relative interaction potency equivalency (PEQ) of a chemical was determined by ratio of interaction potency of a chemical to BPDE as the reference chemical in the reaction with single- and double-stranded oligodeoxynucleotides. PEQs were found to be BPDE > PGE > SO > MMS > Cl(4)HQ for single-stranded oligodeoxynucleotides while they were found to be BPDE > PGE > Cl(4)HQ > MMS > SO for double-stranded oligodeoxynucleotides. Kinetics evaluation revealed that BPDE reacted with both DNA probes at a significantly faster rate, as compared to the remaining test chemicals. Equilibrium was reached within an hour for BPDE, but required a minimum of 48 h for the remaining chemicals. First-order rate constants were (1.61 ± 0.2) × 10(-3) s(-1) and (3.18 ± 0.4) × 10(-4) s(-1) for reaction of BPDE with double- and single-stranded DNA, respectively. The remaining chemicals possessed rate constants from 2 to 13 × 10(-6) s(-1) with a relative kinetic order for reaction with DNA of BPDE ≫ MMS > SO > PGE > Cl(4)HQ for ds-DNA and BPDE ≫ SO ≈ Cl(4)HQ ≈ MMS > PGE for ss-DNA. We further found that the reaction potency, defined by

  3. Trends in aggregate cancer incidence rates in relation to screening and possible overdiagnosis: a word of caution.

    Science.gov (United States)

    Duffy, Stephen W; Michalopoulos, Dimitrios; Sebuødegård, Sofie; Hofvind, Solveig

    2014-03-01

    Overdiagnosis in breast cancer screening is a topic of debate. Researchers often estimate trends in incidence prior to screening and project these to predict incidence during the screening epoch. Data was obtained from the Cancer Registry of Norway and the Norwegian Breast Cancer Screening Programme. Using breast cancer incidence prior to screening in Norway (1976-1995), incidence trends were estimated from age-period and age-cohort models. These estimates were used to predict the incidence of breast cancer in five-year age and period groups in the screening epoch (1996-2009). Excess numbers of cancers in the screening age range (6,876 cancers), and deficits in women above and below the screening age range (1,947 cancers) were observed. However, only part of the observed differences between the observed and the expected incidence can be explained by screening, as evidenced by numbers of excess cancers greater than the numbers of screen-detected cancers in some age groups and time periods. There are potential errors in estimation of overdiagnosis from screening if individual data on screening exposure and detection mode are not taken into account. For reliable estimates of overdiagnosis, it is necessary to compare excess incidence in the screening period in those actually screened with the corresponding excess in those not screened. This is the subject of ongoing research.

  4. Outcome and complications of radical prostatectomy in patients with PSA <10 ng/ml: comparison between the retropubic, perineal and laparoscopic approach.

    Science.gov (United States)

    Salomon, L; Levrel, O; Anastasiadis, A G; Saint, F; de La Taille, A; Cicco, A; Vordos, D; Hoznek, A; Chopin, D; Abbou, C-C

    2002-01-01

    The objective of this work was to evaluate the oncological outcomes and complications of prostate cancer patients with prostate specific antigen (PSA)catetherization (12.1 days), and length of hospital stay (12.1 days) were higher in the retropubic group (P0.05). The actuarial 3-year recurrence-free survival rate was 89.3%, 89.2% and 86.2% (P>0.05) for retropubic, perineal and laparoscopic approach, respectively. It can be concluded that in patients with preoperative PSA<10 ng/ml, clinical outcome and complication rates were similar, regardless of the choice of surgical approach.

  5. Symbolic dynamics marker of heart rate variability combined with clinical variables enhance obstructive sleep apnea screening

    Science.gov (United States)

    Ravelo-García, A. G.; Saavedra-Santana, P.; Juliá-Serdá, G.; Navarro-Mesa, J. L.; Navarro-Esteva, J.; Álvarez-López, X.; Gapelyuk, A.; Penzel, T.; Wessel, N.

    2014-06-01

    Many sleep centres try to perform a reduced portable test in order to decrease the number of overnight polysomnographies that are expensive, time-consuming, and disturbing. With some limitations, heart rate variability (HRV) has been useful in this task. The aim of this investigation was to evaluate if inclusion of symbolic dynamics variables to a logistic regression model integrating clinical and physical variables, can improve the detection of subjects for further polysomnographies. To our knowledge, this is the first contribution that innovates in that strategy. A group of 133 patients has been referred to the sleep center for suspected sleep apnea. Clinical assessment of the patients consisted of a sleep related questionnaire and a physical examination. The clinical variables related to apnea and selected in the statistical model were age (p processing of the HRV is a well established low cost and robust technique.

  6. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich

    2015-01-01

    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  7. Patient-specific prescriber feedback can increase the rate of osteoporosis screening and treatment: results from two national interventions.

    Science.gov (United States)

    Kalisch Ellett, Lisa M; Pratt, N L; Sluggett, J K; Ramsay, E N; Kerr, M; LeBlanc, V T; Barratt, J D; Roughead, E E

    2017-12-01

    Osteoporosis interventions targeting older Australians and clinicians were conducted in 2008 and 2011 as part of a national quality improvement program underpinned by behavioural theory and stakeholder engagement. Uptake of bone mineral density (BMD) tests among targeted men and women increased after both interventions and sustained increases in osteoporosis treatment were observed among men targeted in 2008. Educational interventions incorporating patient-specific prescriber feedback have improved osteoporosis screening and treatment among at-risk patients in clinical trials but have not been evaluated nationally. This study assessed uptake of BMD testing and osteoporosis medicines following two national Australian quality improvement initiatives targeting women (70-79 years) and men (75-85 years) at risk of osteoporosis. Administrative health claims data were used to determine monthly rates of BMD testing and initiation of osteoporosis medicines in the 9-months post-intervention among targeted men and women compared to older cohorts of men and women. Log binomial regression models were used to assess differences between groups. In 2008 91,794 patients were targeted and 52,427 were targeted in 2011. There was a twofold increase in BMD testing after each intervention among targeted patients compared to controls (p theory and stakeholder engagement that target both primary care clinicians and patients can improve osteoporosis screening and management at the national level.

  8. Cervical cancer screening in Germany: group-specific participation rates in the state of Niedersachsen (Lower Saxony). A study with health insurance data.

    Science.gov (United States)

    Geyer, Siegfried; Jaunzeme, Jelena; Hillemanns, Peter

    2015-03-01

    The participation rates in cervical screenings are varying over different countries. This is only partly due to the availability of organized screening programs, as the rates are also varying between countries were such programs were implemented. For Germany the level of knowledge is low, and information are outdated. In order to improve the level of knowledge, we examined whether the participation rates in cervical screenings in a large German insurance population were changing over time, and whether these changes were different with respect to age and qualification of the participating women. The analyses were based on the complete anonymised dataset of a large statutory health insurance in Lower Saxony, Germany, with case numbers between 940,827 (2006) and 1,044,797 (2011) women aged 20 years and older. Between 2006 and 2011 the overall annual participation rates were increasing from 44.8 to 47.6%. The highest rates occurred in women with the highest qualification level, thus leading to increasing social differences over time. There was a peak in the age group of 25-29 years from annually 60.3 (2006) to 60.2% (2011), and bi-annually from 77 to 77.1% with constantly decreasing rates up to the age of 60. No substantial differences occurred between a 2- and a 3-year observation period. Over time only small increases of participation rates in cervical screenings occurred. These findings may be interpreted in favor of population-based screenings within an invitation program.

  9. Diagnostic Role of Serum Free-to-Total Prostate Specific Antigen (PSA) Ratio in Prostate Cancer with Serum Total Concentration of PSA below 4 ng/mL.

    Science.gov (United States)

    Chang, Chih-Chun; Lee, Yi-Chen; Tsai, Huang-Wen; Yii, Shyi-Chun; Yen, Tzung-Hai; Chu, Fang-Yeh

    2015-01-01

    To examine the effectiveness of serum free-to-total prostate specific antigen ratio (%fPSA) for the detection of prostate cancer (PCa) in men with different serum total PSA (tPSA) categories. From January 2010 to December 2013, a total of 225 patients with lower urinary tract symptoms (LUTS) underwent tPSA and %fPSA measurements. Histological examination with calculation of Gleason score and whole body bone scans were performed in identified cases of PCa. PCa was diagnosed in 44 (19.6%) patients and the remaining 181 patients had benign prostate disease. PCa was detected in 5 (23.8%), 13 (8.7%) and 26 (47.3%) cases with tPSA level ranges≤4 ng/ml, 4 to 10 ng/ml and >10 ng/ml, respectively. The average Gleason score was 7.2±0.2. Some 6 (13.6%) out of 44 PCa patients had bone metastases. The sensitivity was 80% and specificity was 81.3% at the cut-off %fPSA of 15% in PCa patients with a tPSA level below 4 ng/ mL. A lower %fPSA was associated with PCa patients with Gleason score≥7 than those with Gleason score≤6 (11.7±0.98 vs. 16.5±2.25%, P=0.029). No obvious relation of %fPSA to the incidence of bone metastasis was apparent in this study. The clinical application of %fPSA could help to discriminate PCa from benign prostate disease in men with a tPSA concentration below 4 ng/mL.

  10. Prostate cancer in patients from rural and suburban areas--PSA value, Gleason score and presence of metastases in bone scan.

    Science.gov (United States)

    Szot, Wojciech; Kostkiewicz, Magdalena; Zając, Joanna; Owoc, Alfred; Bojar, Iwona

    2014-01-01

    Prostate cancer is the second most common neoplasm among men both worldwide and in Poland. In prostate cancer, bone metastasis is related to a poorer prognosis. A diagnosis of metastatic bone disease is important in prostate cancer patients prior to therapy. Prostate specific antigen (PSA) serum value is used both as a screening tool and for staging of prostate cancer. To evaluate whether there is a link between symptoms presented by patients, pain in particular, and the presence, number and location of bone metastases as assessed by bone scan scintigraphy in concordance with PSA values and Gleason scores. A group of 186 patients (aged: 68.38±6.16) diagnosed with prostate cancer, from rural and suburban areas of Małopolska province, that was directed for bone scan scintigraphy to the Nuclear Medicine Dept, John Paul II Hospital in Kraków. Analysis of all laboratory findings (including PSA value) and a biopsy were performed. Then, bone scan scintigraphy was done with the use of methylene disphosphonate (MDP) labeled with Tc-99m. In patients with a Gleason value≤7 and a PSA value≤20 ng/ml, the cutoff value for a negative bone scan with a confidence interval of 0.95 was established at a PSA value below 10 ng/ml (pbone scan (r=0.45, p=0.05), the number of metastases (r=0.66, pbone scan scintigraphy in prostate cancer staging. The cutoff value for negative bone scan with a 95% confidence interval was established at PSA=10 ng/ml.

  11. High Rates of Anal High-Grade Squamous Intraepithelial Lesions in HIV-Infected Women Who Do Not Meet Screening Guidelines.

    Science.gov (United States)

    Gaisa, Michael; Ita-Nagy, Fanny; Sigel, Keith; Arens, Yotam; Hennessy, Mary Ann; Rodriguez-Caprio, Gabriela; Mullen, Michael; Aberg, Judith A; Cespedes, Michelle

    2017-02-01

    Human immunodeficiency virus (HIV)-infected women have a higher burden of anal high-grade squamous intraepithelial lesions (HSIL) and anal cancer (AC) compared with HIV-uninfected women. Guidelines for AC screening in this population are heterogeneous. Here we report outcomes and risk factors for anal HSIL following implementation of universal AC screening offered to all HIV-infected women. Data from women who underwent AC screening with anal cytology from April 2009 to July 2014 were analyzed. Routine clinical data included anal and cervical cytology, demographic/behavioral data, and high-resolution anoscopy (HRA) results. We evaluated the association of cytology with HRA results, and predictors of HSIL pathology, and compared rates of HSIL pathology among women meeting screening guidelines to those who did not. Seven hundred forty-five HIV-infected women were screened with anal cytology. Thirty-nine percent had abnormal anal cytology on initial screen and 15% on secondary screen; 208 women underwent HRA following abnormal anal cytology. HSIL was found in 26% and 18% of anal biopsies following initial and secondary screening, respectively. One woman had AC. Cigarette smoking more than doubled HSIL risk. Among women who underwent AC screening despite not meeting existing guideline criteria, 21% and 10%, respectively, were found to have HSIL on biopsy. Neither meeting criteria for screening nor history of receptive anal sex was significantly associated with HSIL. Anal HSIL is common in HIV-infected women. Substantial numbers of HSIL would have been missed by strictly adhering to existing AC screening guidelines. These results support routine screening of all HIV-infected women regardless of human papillomavirus history or sexual practices. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  12. OSTEOARTICULAR INJURY IN PSORIATIC PATIENTS ACCORDING TO THE DATA OF PEST (PSORIASIS EPIDEMIOLOGY SCREENING TOOL QUESTIONNAIRE AND RHEUMATOLOGICAL CLINICOINSTRUMENTAL EXAMINATION

    Directory of Open Access Journals (Sweden)

    M. N. Chamurlieva

    2014-01-01

    Full Text Available Objective: to estimate the prevalence of psoriatic arthritis (PsA and the pattern of osteoarticular injury in psoriatic patients according to the data of the PEST (Psoriasis Epidemiology Screening Tool questionnaire.Subjects and methods. The trial included 80 psoriatic patients who had sought for dermatological and rheumatological advice (35 men and 45 women; mean age 43.06±1.71 years; psoriatic skin damage area (PSDA 9.83±2.63%; and psoriasis area severity index (PASI 12.05±3.23; dermatology life quality index (DQLI 8.57±0.94. Answers to 6 questions about nail psoriasis in the PEST questionnaire were rated; each positive answer corresponded to 1; PEST ≥3 or <3 is indicative of the presence or absence of psoriasis, respectively. All patients, irrespectively of PEST value, were examined by a rheumatologist and underwent a standard clinicoinstrumental examination. The CASPAR criteria were considered to be a gold standard of PsA diagnosis.Results. 53 (66.2% patients had PEST≥3; the CASPAR criteria confirmed PsA in 40 (75.4% of them. 27 (33.8% patients had PEST<3; in 13 (48% of them, fulfilled CASPAR criteria. PsA was first diagnosed in 30 (56.6% of the 53 patients. Thus, PsA was identified in 53 (66.2% of the 80 patients; another rheumatic disease (RD, such as dermatomyositis, rheumatic polymyalgia, osteoarthritis, ankylosing spondylitis, reactive arthritis, rheumatoid arthritis (RA, gout, etc., was found in 10 (12.5%; a concurrence of RDs (RA and gout in 3 (3.7%; RD was absent in 14 (17.5% cases. The disease duration was <1 year in 17 (34% of the 53 patients with PsA, 1 to 2 years in 16 (32%, 2 to 3 years in 11 (22%, and ≥3 years in 9 (18%. Nail psoriasis was detected in 55 (70% patients. It was found in 38 (71.7% patients with PsA and in 17 without this disease. In patients with PsA, PSDA averaged 7.23±2.24%; PASI 11.69±1.94; DQLI 7.71±0.17, respectively; in those without PsA 11.44±2.78%, 14.94±4.29, and 8.96±1

  13. Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009

    Directory of Open Access Journals (Sweden)

    Kumban Walter Chuck

    2017-08-01

    Full Text Available OBJECTIVES To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes. METHODS Data from the Korea National Health and Nutrition Examination Survey (2007-2009 were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes. RESULTS Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer. Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001, breast cancer (38.8 vs. 44.6%, p<0.001, and cervical cancer (35.1 vs. 51.2%, p<0.001. In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9, and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9. CONCLUSIONS The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.

  14. A human immunodeficiency virus screening algorithm to address the high rate of false-positive results in pregnant women in Japan.

    Directory of Open Access Journals (Sweden)

    Takako Shima-Sano

    Full Text Available BACKGROUND: Prenatal human immunodeficiency virus (HIV testing is essential for the prevention of mother-to-child transmission. However, false-positive results of screening testing are a concern as they may cause unnecessary emotional stress to pregnant women waiting for confirmatory test results. In regions with an extremely low prevalence, the positive predictive values of screening are unacceptably low rate. Here, we propose a HIV screening algorithm consisting of serial two fourth-generation enzyme immunoassays to reduce the number of false-positive screening results. METHODOLOGY/PRINCIPAL FINDINGS: When 6461 pregnant women presenting to two maternity hospitals located in the Tokyo metropolitan area of Japan from September, 2004 to January, 2006 were tested using Enzygnost HIV Integral as a first screening test, 27 showed positive reactions. When these positive reaction samples were tested using VIDAS HIV DUO Quick as a second screening test, only one of them had a positive reaction, and the remaining 26 were nonreactive. Confirmatory Western blots and nucleic acid amplification test also showed that one was positive and the remaining 26 were negative; the subject who was positive with the confirmatory tests was identical to the subject who was positive with the second screening test. Thus, by adding the second screening test, the false-positive rate was improved from 0.4% to 0%, and the positive predictive value from 3.7% to 100%, compared with the single screening test. CONCLUSION: By applying our serial screening algorithm to HIV testing in maternity hospitals, many uninfected pregnant women would not need to receive confirmatory tests and be subjected to emotional turmoil while waiting for their confirmatory test results. This algorithm would be suitable for HIV testing of pregnant women living in low prevalence regions such as Japan.

  15. A human immunodeficiency virus screening algorithm to address the high rate of false-positive results in pregnant women in Japan.

    Science.gov (United States)

    Shima-Sano, Takako; Yamada, Rika; Sekita, Kazuyo; Hankins, Raleigh W; Hori, Hiromasa; Seto, Hiroshi; Sudo, Koji; Kondo, Makiko; Kawahara, Kazuo; Tsukahara, Yuki; Inaba, Noriyuki; Kato, Shingo; Imai, Mitsunobu

    2010-02-23

    Prenatal human immunodeficiency virus (HIV) testing is essential for the prevention of mother-to-child transmission. However, false-positive results of screening testing are a concern as they may cause unnecessary emotional stress to pregnant women waiting for confirmatory test results. In regions with an extremely low prevalence, the positive predictive values of screening are unacceptably low rate. Here, we propose a HIV screening algorithm consisting of serial two fourth-generation enzyme immunoassays to reduce the number of false-positive screening results. When 6461 pregnant women presenting to two maternity hospitals located in the Tokyo metropolitan area of Japan from September, 2004 to January, 2006 were tested using Enzygnost HIV Integral as a first screening test, 27 showed positive reactions. When these positive reaction samples were tested using VIDAS HIV DUO Quick as a second screening test, only one of them had a positive reaction, and the remaining 26 were nonreactive. Confirmatory Western blots and nucleic acid amplification test also showed that one was positive and the remaining 26 were negative; the subject who was positive with the confirmatory tests was identical to the subject who was positive with the second screening test. Thus, by adding the second screening test, the false-positive rate was improved from 0.4% to 0%, and the positive predictive value from 3.7% to 100%, compared with the single screening test. By applying our serial screening algorithm to HIV testing in maternity hospitals, many uninfected pregnant women would not need to receive confirmatory tests and be subjected to emotional turmoil while waiting for their confirmatory test results. This algorithm would be suitable for HIV testing of pregnant women living in low prevalence regions such as Japan.

  16. False positives in breast cancer screening with one-view breast tomosynthesis: An analysis of findings leading to recall, work-up and biopsy rates in the Malmö Breast Tomosynthesis Screening Trial.

    Science.gov (United States)

    Lång, Kristina; Nergården, Matilda; Andersson, Ingvar; Rosso, Aldana; Zackrisson, Sophia

    2016-11-01

    To analyse false positives (FPs) in breast cancer screening with tomosynthesis (BT) vs. mammography (DM). The Malmö Breast Tomosynthesis Screening Trial (MBTST) is a prospective population-based study comparing one-view BT to DM in screening. This study is based on the first half of the MBTST population (n = 7,500). Differences in FP recall rate, findings leading to recall, work-up and biopsy rate between cases recalled on BT alone, DM alone and BT+DM were analysed. The FP recall rate was 1.7 % for BT alone (n = 131), 0.9 % for DM alone (n = 69) and 1.1 % for BT + DM (n = 81). The FP recall rate for BT alone was halved after the initial phase of the trial, stabilising at 1.5 %. BT doubled the recall of stellate distortions compared to DM (n = 64 vs. n = 33). There were fewer fibroadenomas and cysts, and the biopsy rate was slightly lower for FP recalled on BT alone compared to DM alone (15.3 % vs. 27.6 %: p = 0.037 and 33.8 % vs. 36.2 %; p = 0.641, respectively). FPs increased with BT screening mainly due to the recall of stellate distortions. The FP recall rate was still well within the European guidelines and showed evidence of a learning curve. Characterisation of rounded lesions was improved with BT. • Tomosynthesis screening gave a higher false-positive recall rate than mammography • There was a decline in the false-positive recall rate for tomosynthesis • The recall due to stellate distortions simulating malignancy was doubled with tomosynthesis • Tomosynthesis found more radial and postoperative scar tissue than mammography • Tomosynthesis is better at characterising rounded lesions.

  17. Salvage radiotherapy for biochemical relapse after complete PSA response following radical prostatectomy: outcome and prognostic factors for patients who have never received hormonal therapy

    Directory of Open Access Journals (Sweden)

    Novaes Paulo ERS

    2007-02-01

    Full Text Available Abstract Objectives To evaluate the results of salvage conformal radiation therapy (3DC-EBRT for patients submitted to radical prostatectomy (RP who have achieved complete PSA response and who have never been treated with hormonal therapy (HT. To present the results of biochemical control, a period free from hormonal therapy and factors related to its prognosis. Materials and methods from August 2002 to December 2004, 43 prostate cancer patients submitted to RP presented biochemical failure after achieving a PSA Results 3-year biochemical non-evidence of disease (BNED was 71%. PSA doubling time lower than 4 months (p = 0.01 and time from recurrence to salvage EBRT (p = 0.04 were associated with worse chance of biochemical control. Biochemical control of 76% was achieved when RT had been introduced with a PSA lower than 1 ng/ml vs. 48% with a PSA higher than 1 (p = 0.19. Late toxicity was acceptable. Conclusion 70% of biochemical control in 3 years can be achieved with salvage radiotherapy in selected patients. The importance of PSADT was confirmed in this study and radiotherapy should be started as early as possible. Longer follow up is necessary, but it is possible to conclude that a long interval free from hormonal therapy was achieved with low rate of toxicity avoiding or at least delaying several important adverse effects related to hormonal treatment.

  18. Confirmation rates of array-CGH in day-3 embryo and blastocyst biopsies for preimplantation genetic screening.

    Science.gov (United States)

    Mir, P; Mateu, E; Mercader, A; Herrer, R; Rodrigo, L; Vera, M; Peinado, V; Milán-Sánchez, M; Campos-Galindo, I; García-Herrero, S; Simón, C; Rubio, C

    2016-01-01

    The purpose of this study was to compare the confirmation rate of day-3 embryo biopsy (blastomere) and trophectoderm biopsy using array-comparative genomic hybridization (array-CGH) technology. A blinded study was conducted to re-analyse 109 embryos previously diagnosed as chromosomally abnormal by array-CGH. Preimplantation genetic screening (PGS) was performed using array-CGH on day 3 (n = 50) or day 5 (n = 59). Partial chromosome gains or losses were excluded (n=6), and only whole chromosome aneuploidies were considered. Re-analysis of whole blastocysts was carried out following the same array-CGH protocol used for PGS. The PGS result was confirmed in the whole blastocyst in (a) 49/50 (98 %) abnormal embryos after day-3 biopsy and (b) 57/59 (96.6 %) abnormal embryos after trophectoderm biopsy. One embryo (1/50; 2 %) was diagnosed as abnormal, with monosomy 18, on day 3, and software analysis of the whole blastocyst gave a euploid result; however, a mosaic pattern was observed for monosomy 18 in the whole blastocyst. Two trophectoderm biopsy cases (3.4 %) did not have the abnormalities (trisomy 7, and trisomy 1 and 4, respectively) verified in the whole embryo. Concordance rates for both biopsy strategies and for individual chromosomes were evaluated by Fisher's exact test and showed no significant differences. Both types of biopsies showed similar high concordance rates with whole blastocyst results. Therefore, regarding the confirmation rates shown in this work, day-3 embryo biopsies can be representative of the whole embryo and both types of biopsy can be used for clinical analysis in PGS following the described array-CGH protocol.

  19. Take Charge. Take the Test. "You Know" PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-03-07

    As part of the Take Charge. Take the Test. campaign, this 60 second PSA encourages African American women to get tested for HIV. Locations for a free HIV test can be found by visiting hivtest.org/takecharge or calling 1-800-CDC-INFO (1-800-232-4636).  Created: 3/7/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/7/2012.

  20. Teen Pregnancy - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-04-05

    This 60 second PSA is based on the April, 2011 CDC Vital Signs report. Having a child during the teen years comes at a high cost to the young mother, her child, and the community. Get tips to help break the cycle of teen pregnancy.  Created: 4/5/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/5/2011.

  1. Asthma - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-05-03

    This 60 second Public Service Announcement (PSA) is based on the May, 2011 CDC Vital Signs report. Children and adults can have asthma and attacks can be frightening. To help control asthma, know the warning signs of an attack, stay away from asthma triggers, and follow your health care provider's advice.  Created: 5/3/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 5/3/2011.

  2. Screened-exchange density functional approach to Auger recombination and impact ionization rates in InGaAs

    Science.gov (United States)

    Picozzi, Silvia; Asahi, Ryoji; Geller, Clint; Freeman, Arthur

    2004-03-01

    We present an ab-initio modeling approach for Auger recombination and impact ionization in semiconductors directed at i) quantitative rate determinations and 2) elucidating trends with respect to alloy composition, carrier concentration and temperature. We present a fully first-principles formalism (S.Picozzi, R.Asahi, C.B. Geller and A.J.Freeman, Phys.Rev.Lett. 89, 197601 (2002); Phys.Rev.B 65, 113206 (2002).), based on accurate energy bands and wave functions within the screened exchange local density approximation and the full-potential linearized augmented plane wave (FLAPW) method (E.Wimmer, H.Krakauer, M.Weinert, A.J.Freeman, Phys.Rev.B 24, 864 (1981)). Results are presented for electron- and hole-initiated impact ionization processes and Auger recombinations for p-type and n-type InGaAs. Anisotropy and composition effects in the related rates are discussed in terms of the underlying band-structures. Calculated Auger lifetimes, in general agreement with experiments, are studied for different recombination mechanisms (i.e. CCCH, CHHL, CHHS, involving conduction electrons (C), heavy- (H) and light-hole (L), spin split-off (S) band) in order to understand the dominant mechanism.

  3. Reliance of Wolbachia on High Rates of Host Proteolysis Revealed by a Genome-Wide RNAi Screen of Drosophila Cells.

    Science.gov (United States)

    White, Pamela M; Serbus, Laura R; Debec, Alain; Codina, Adan; Bray, Walter; Guichet, Antoine; Lokey, R Scott; Sullivan, William

    2017-04-01

    Wolbachia are gram-negative, obligate, intracellular bacteria carried by a majority of insect species worldwide. Here we use a Wolbachia-infected Drosophila cell line and genome-wide RNA interference (RNAi) screening to identify host factors that influence Wolbachia titer. By screening an RNAi library targeting 15,699 transcribed host genes, we identified 36 candidate genes that dramatically reduced Wolbachia titer and 41 that increased Wolbachia titer. Host gene knockdowns that reduced Wolbachia titer spanned a broad array of biological pathways including genes that influenced mitochondrial function and lipid metabolism. In addition, knockdown of seven genes in the host ubiquitin and proteolysis pathways significantly reduced Wolbachia titer. To test the in vivo relevance of these results, we found that drug and mutant inhibition of proteolysis reduced levels of Wolbachia in the Drosophila oocyte. The presence of Wolbachia in either cell lines or oocytes dramatically alters the distribution and abundance of ubiquitinated proteins. Functional studies revealed that maintenance of Wolbachia titer relies on an intact host Endoplasmic Reticulum (ER)-associated protein degradation pathway (ERAD). Accordingly, electron microscopy studies demonstrated that Wolbachia is intimately associated with the host ER and dramatically alters the morphology of this organelle. Given Wolbachia lack essential amino acid biosynthetic pathways, the reliance of Wolbachia on high rates of host proteolysis via ubiquitination and the ERAD pathways may be a key mechanism for provisioning Wolbachia with amino acids. In addition, the reliance of Wolbachia on the ERAD pathway and disruption of ER morphology suggests a previously unsuspected mechanism for Wolbachia's potent ability to prevent RNA virus replication. Copyright © 2017 by the Genetics Society of America.

  4. Comparative full-band Monte Carlo study of Si and Ge with screened pseudopotential-based phonon scattering rates

    Science.gov (United States)

    Nguyen, Phuong Hoa; Hofmann, Karl R.; Paasch, Gernot

    2003-07-01

    In a previous article [J. Appl. Phys. 92, 5359 (2002)], we presented a combination of a full-band Monte Carlo method using an advanced band structure and a variable Brillouin zone discretization, with phonon scattering rates based on the screened pseudopotential considering the positions of the atoms in the elementary cell. To make the method suitable for sufficiently fast applications, such as device simulations, the simplest wave number dependent approximation was introduced. It contains an average of the cell structure factor, and only two fit parameters: The acoustic and the optical deformation potentials. As the pseudopotential, the Ashcroft model potential is chosen, and screening is taken into account using the Lindhard dielectric function. In the present article, based on the study of the influence of the two deformation potentials on the electron and hole drift velocities in Si and Ge, we show how to select the deformation potentials. Depending on the targeted agreement with experimental results, the pairs of deformation potentials for electrons and holes can be used uniformly for a wide temperature range or separately for different temperatures. For Ge, we achieve remarkable quantitative agreement with the temperature, field, and orientation dependencies of experimental electron and hole drift velocities in the wide temperature range from 77 to 300 K with a single set of the two deformations potentials for each carrier type. A detailed comparative simulation of the transport properties in Ge and Si at different temperatures is presented which is comprised of the steady-state dependence of the drift velocity on the electric field, the low-field mobility, and transient transport. Peculiarities of the drift velocity-field dependencies, such as the anisotropy, and a negative differential mobility are discussed in terms of the different band structures in connection with the field dependence of the simulated distribution functions. For doped materials, ionized

  5. Prostate Cancer Screening in Jamaica: Results of the Largest National Screening Clinic

    Directory of Open Access Journals (Sweden)

    Belinda F. Morrison

    2016-01-01

    Full Text Available Prostate cancer is highly prevalent in Jamaica and is the leading cause of cancer-related deaths. Our aim was to evaluate the patterns of screening in the largest organized screening clinic in Jamaica at the Jamaica Cancer Society. A retrospective analysis of all men presenting for screening at the Jamaica Cancer Society from 1995 to 2005 was done. All patients had digital rectal examinations (DRE and prostate specific antigen (PSA tests done. Results of prostate biopsies were noted. 1117 men of mean age 59.9 ± 8.2 years presented for screening. The median documented PSA was 1.6 ng/mL (maximum of 5170 ng/mL. Most patients presented for only 1 screen. There was a gradual reduction in the mean age of presentation for screening over the period. Prostate biopsies were requested on 11% of screening visits; however, only 59% of these were done. 5.6% of all persons screened were found to have cancer. Of the cancers diagnosed, Gleason 6 adenocarcinoma was the commonest grade and median PSA was 8.9 ng/mL (range 1.5–1059 ng/mL. Older men tend to screen for prostate cancer in Jamaica. However, compliance with regular maintenance visits and requests for confirmatory biopsies are poor. Screening needs intervention in the Jamaican population.

  6. [Cancer screening: curative or harmful? An ethical dilemma facing the physician].

    Science.gov (United States)

    Schaefer, C; Weissbach, L

    2011-12-01

    Early detection based on prostate-specific antigen (PSA) presumably can reduce prostate cancer mortality. At the same time it is associated with a comparatively high rate of overdiagnosis involving tumors that would not have become apparent without screening since they would have remained asymptomatic during the patient's entire life. Current studies show that the probability of such an overdiagnosis is 12-48 times higher than one which would save a man's life. Thus, overdiagnosis poses an ethical dilemma for physicians: their actions (screening examination) can turn a healthy individual into a chronically ill person. This profoundly contradicts the principle of medical ethics to"do no harm." An open debate on whether early detection can be reconciled with doctors' ethical duties is hampered by the implications of liability law, faulty economic incentives, and the pressures of competition as well as the empirical practice of many physicians to overestimate the benefits of cancer screening.

  7. Joint association of screen time and physical activity on self-rated health and life satisfaction in children and adolescents: the CASPIAN-IV study.

    Science.gov (United States)

    Matin, Nassim; Kelishadi, Roya; Heshmat, Ramin; Motamed-Gorji, Nazgol; Djalalinia, Shirin; Motlagh, Mohammad Esmaeil; Ardalan, Gelayol; Arefirad, Tahereh; Mohammadi, Rasool; Safiri, Saeid; Qorbani, Mostafa

    2017-01-01

    Self-rated health and life satisfaction are two subjective measures for assessing overall health status. This study aims to investigate the association of self-rated health and life satisfaction with physical activity and screen time. As part of the fourth survey of a national surveillance program in Iran (CASPIAN-IV study), 14 880 students aged 6 to 18 years were selected via multi-stage cluster sampling from 30 provinces. Data were obtained from the WHO Global School-Based Student Health Survey questionnaire. A total of 13 486 students with mean age of 12.47 (SD 3.36) completed the study. In crude model both prolonged screen time and physical activity were associated with favorable life satisfaction and self-rated health. However, in multivariate analysis only high physical activity was associated with good self-rated health (OR 1.37) and life satisfaction (OR 1.39), while prolonged screen time was not associated with good self-rated health (OR 1.02) and life satisfaction (OR 0.94). For combined screen time-physical activity variable, low screen time-high physical activity combination had the highest OR for both good self-rated health (OR 1.37) and life satisfaction (OR 1.43) in multivariate analysis. Our findings suggest that increasing physical activity is more crucial than emphasizing reducing screen time in improving the well-being of children and adolescents. © The Author 2016. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Cancer fatalism and poor self-rated health mediate the association between socioeconomic status and uptake of colorectal cancer screening in England.

    Science.gov (United States)

    Miles, Anne; Rainbow, Sandra; von Wagner, Christian

    2011-10-01

    Little is known about the psychological predictors of colorectal screening uptake in England and mediators of associations between uptake and socioeconomic status (SES). This study tested the hypotheses that although higher threat and efficacy beliefs, lower cancer fatalism, lower depression, and better self-rated health would predict higher screening uptake, only efficacy beliefs, fatalism, depression, and self-rated health would mediate associations between uptake and SES. Data from 529 adults aged 60 to 69 who had completed a postal survey in 2005-2006 were linked with data on fecal occult blood test (FOBt) uptake recorded at the screening "hub" following its introduction in 2007, resulting in a prospective study. Screening uptake was 56% and was higher among people with higher SES, better self-rated health, higher self-efficacy beliefs, and lower cancer fatalism in univariate analyses. Path analysis on participants with complete data (n = 515) showed that both better self-rated health and lower cancer fatalism were directly associated with higher uptake of FOBt screening and significantly mediated pathways from SES to uptake. Lower depression only had an indirect effect on uptake through better self-rated health. Efficacy beliefs did not mediate the relationship between SES and uptake. SES differences in uptake of FOBt in England are partially explained by differences in cancer fatalism, self-rated health, and depression. This is one of only a few studies to examine mediators of the relationship between SES and screening uptake, and future research could test the effectiveness of interventions to reduce fatalistic beliefs to increase equality of uptake. ©2011 AACR

  9. Discoveries and application of prostate-specific antigen, and some proposals to optimize prostate cancer screening

    Directory of Open Access Journals (Sweden)

    Tokudome S

    2016-05-01

    Full Text Available Shinkan Tokudome,1 Ryosuke Ando,2 Yoshiro Koda,3 1Department of Nutritional Epidemiology, National Institute of Health and Nutrition, Shinjuku-ku, Tokyo, 2Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Mizuho-ku, Nagoya, 3Department of Forensic Medicine and Human Genetics, Kurume University School of Medicine, Kurume, Japan Abstract: The discoveries and application of prostate-specific antigen (PSA have been much appreciated because PSA-based screening has saved millions of lives of prostate cancer (PCa patients. Historically speaking, Flocks et al first identified antigenic properties in prostate tissue in 1960. Then, Barnes et al detected immunologic characteristics in prostatic fluid in 1963. Hara et al characterized γ-semino-protein in semen in 1966, and it has been proven to be identical to PSA. Subsequently, Ablin et al independently reported the presence of precipitation antigens in the prostate in 1970. Wang et al purified the PSA in 1979, and Kuriyama et al first applied an enzyme-linked immunosorbent assay for PSA in 1980. However, the positive predictive value with a cutoff figure of 4.0 ng/mL appeared substantially low (~30%. There are overdiagnoses and overtreatments for latent/low-risk PCa. Controversies exist in the PCa mortality-reducing effects of PSA screening between the European Randomized Study of Screening for Prostate Cancer (ERSPC and the US Prostate, Lung, Colorectal, and Ovarian (PLCO Cancer Screening Trial. For optimizing PCa screening, PSA-related items may require the following: 1 adjustment of the cutoff values according to age, as well as setting limits to age and screening intervals; 2 improving test performance using doubling time, density, and ratio of free: total PSA; and 3 fostering active surveillance for low-risk PCa with monitoring by PSA value. Other items needing consideration may include the following: 1 examinations of cell proliferation and cell cycle markers

  10. Image Guided Hypofractionated Radiotherapy by Helical Tomotherapy for Prostate Carcinoma: Toxicity and Impact on Nadir PSA

    Directory of Open Access Journals (Sweden)

    Salvina Barra

    2014-01-01

    Full Text Available Aim. To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT of prostate cancer as well as the value of the nadir PSA (nPSA and time to nadir PSA (tnPSA as surrogate efficacy of treatment. Material and Methods. Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT. A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy. Results. Most of patients (83% did not develop acute gastrointestinal (GI toxicity and 50% did not present genitourinary (GU toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL of the conventionally treated cohort (P=0.02. Conclusions. Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.

  11. [Prostate specific antigen--PSA and histopathological findings of endometrium in women with fibrocystic breast disease].

    Science.gov (United States)

    Radowicki, Stanisław; Kunicki, Michał

    2010-02-01

    The aim of the study was to evaluate the relationship between serum free and total PSA and histopathological findings in women with fibrocystic mastopathy. 176 women with fibrocystic breast disease, aged 18 to 45 years.--Group I: comprised 114 patients with cysts 10 mm in diameter. The control group consisted of 46 healthy women aged 18 - 45 years who had no breast pathology Total PSA (PSA-T) and free PSA (PSA-Free) were measured by an ultra-sensitive fluoroimmunometric DELFIA assay (Prostatus PSA Free/Total Wallac, Turku, Finland). The detection limit for PSA was 0.01 ng/ml. Endometrial samples have been obtained with Pipelle probe between 22 and 24 days of the menstrual cycle. In the control group secretory endometrium was more frequently detected than in the mastopathy group (chi2 = 11,15, p = 0.01). Proliferatory (chi2 = 8.27, p = 0.004) and presecretory endometrium (chi2 = 4.61, p = 0.03) were more frequently detected in the mastopathy group than in controls. We did not find statistically significant relationship between the mean PSA concentrations between the groups in relation to histopathological findings. No relationships between free and total PSA measured in the follicular phase of the menstrual cycle and endometrial findings were detected in our study. Further research is required to evaluate the relationship between PSA and endometrial findings.

  12. Prostate-specific antigen screening and mortality from prostate cancer.

    Science.gov (United States)

    Marcella, Stephen W; Rhoads, George G; Carson, Jeffrey L; Merlino, Frances; Wilcox, Homer

    2008-03-01

    There is no available evidence from randomized trials that early detection of prostate cancer improves health outcomes, but the prostate-specific antigen (PSA) test is commonly used to screen men for prostate cancer. The objective of the study is to see if screening with PSA decreases mortality from prostate cancer. This is a case-control study using one-to-one matching on race, age, and time of availability of exposure to PSA screening. Decedents, 380, from New Jersey Vital Statistics 1997 to 2000 inclusive, 55-79 years of age at diagnosis were matched to living controls without metastatic prostate cancer. Medical records were obtained from all providers, and we abstracted information about PSA tests from 1989 to the time of diagnosis in each index case. Measurements consist of a comparison of screening (yes, no) between cases and controls. Measure of association was the odds ratio. Eligible cases were diagnosed each year from 1989 to 1999 with the median year being 1993. PSA screening was evident in 23.2-29.2% of cases and 21.8-26.1% of controls depending on the screening criteria. The unadjusted, matched odds ratio for dying of prostate cancer if ever screened was 1.09 (95% CI 0.76 to 1.60) for the most restrictive criteria and 1.19 (95% CI, 0.85 to 1.66) for the least restrictive. Adjustment for comorbidity and education level made no significant differences in these values. There were no significant interactions by age or race. PSA screening using an ever/never tabulation for tests from 1989 until 2000 did not protect New Jersey men from prostate cancer mortality.

  13. Patient-Provider Communication About Prostate Cancer Screening and Treatment: New Evidence From the Health Information National Trends Survey.

    Science.gov (United States)

    Bhuyan, Soumitra S; Chandak, Aastha; Gupta, Niodita; Isharwal, Sudhir; LaGrange, Chad; Mahmood, Asos; Gentry, Dan

    2015-11-26

    The American Urological Association, American Cancer Society, and American College of Physicians recommend that patients and providers make a shared decision with respect to prostate-specific antigen (PSA) testing for prostate cancer (PCa). The goal of this study is to determine the extent of patient-provider communication for PSA testing and treatment of PCa and to examine the patient specific factors associated with this communication. Using recent data from the Health Information National Trends Survey, this study examined the association of patient characteristics with four domains of patient-provider communication regarding PSA test and PCa treatment: (1) expert opinion of PSA test, (2) accuracy of PSA test, (3) side effects of PCa treatment, and (4) treatment need of PCa. The current results suggested low level of communication for PSA testing and treatment of PCa across four domains. Less than 10% of the respondents report having communication about all four domains. Patient characteristics like recent medical check-up, regular healthcare provider, global health status, age group, marital status, race, annual household income, and already having undergone a PSA test are associated with patient-provider communication. There are few discussions about PSA testing and PCa treatment options between healthcare providers and their patients, which limits the shared decision-making process for PCa screening and treatment as recommended by the current best practice guidelines. This study helps identify implications for changes in physician practice to adhere with the PSA screening guidelines. © The Author(s) 2015.

  14. Arbitration of discrepant BI-RADS 0 recalls by a third reader at screening mammography lowers recall rate but not the cancer detection rate and sensitivity at blinded and non-blinded double reading.

    Science.gov (United States)

    Klompenhouwer, E G; Weber, R J P; Voogd, A C; den Heeten, G J; Strobbe, L J A; Broeders, M J M; Tjan-Heijnen, V C G; Duijm, L E M

    2015-10-01

    To evaluate the characteristics of low suspicion lesions (BI-RADS 0) at blinded and non-blinded double reading of screening mammograms and to determine the potential effect of arbitration of discrepant BI-RADS 0 recalls by a third reader on screening outcome. We included a series of 84,927 consecutive digital screening mammograms, double read in a blinded (43,184 screens) or non-blinded (41,743 screens) fashion, between July 2009 and July 2011. Discrepant readings were routinely recalled for further evaluation. During 2 years of follow-up, radiology, surgical and pathology reports were collected of all recalled women. Arbitration of discrepant BI-RADS 0 recalls (only one radiologist assigning a BI-RADS 0 score) was retrospectively performed by a third screening radiologist. At blinded and non-blinded double reading, 32.0% and 32.5% of recalls were assigned BI-RADS 0 with a positive predictive value (PPV) of 7.2% and 6.8%, respectively. Compared to non-blinded double reading, BI-RADS 0 recalls at blinded double reading showed a higher discrepancy rate (9.0 versus 4.3 per 1000 screens, p Arbitration of discrepant BI-RADS 0 recalls would have significantly lowered recall rate (from 3.4% to 2.8% at blinded double reading, p Arbitration would have significantly increased the PPV at blinded double reading (from 22.3% to 26.3%, p = 0.015). We advise arbitration of discrepant BI-RADS 0 recalls, at (non-)blinded double reading of screening mammograms, to reduce recall rates and improve the PPV of recall at blinded double reading. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Prostate cancer screening in Ghana - a clinical benefit? | Arthur ...

    African Journals Online (AJOL)

    In Ghana and most African countries, prostate cancer is the most common cancer in males after hepatocellular carcinoma. Whereas in the advanced countries, screening for prostate specific antigen (PSA) has led to early detection and management of the disease, screening has been very low in Ghana, thus leading to low ...

  16. Urdu translation and validation of GAD-7: A screening and rating tool for anxiety symptoms in primary health care.

    Science.gov (United States)

    Ahmad, Sabih; Hussain, Sadiq; Shah, Farrukh Saleem; Akhtar, Farrukh

    2017-10-01

    To translate and validate Generalized Anxiety Disorder -7scale in Urdu, for use in Pakistan in the primary healthcare setups. The validation study was conducted at the Combined Military Hospital, Gilgit, Pakistan, from February to May 2016.We followed a systematic six-step process to validate the Generalized Anxiety Disorder-7 scale in the target population. The instrument was translated independently and then fused together. Back-translation was followed by recommendations by an expert committee, and face validity improvement by a language expert. A pilot study was done to get user's feedback on the construct. Volunteers were administered the questionnaire for validation procedure, along with a well-being scale, at three different cities representing volunteers from four different administrative regions of Pakistan. There were 285 volunteers in the study. Principal component exploratory factor analysis supported unidimensional structure of the scale with an eigenvalue of 5.18 and it explained 64.8% of the total variance. Total score on the scale was negatively correlated with positive effect (r = -0.44, pUrdu tool to screen, rate, and monitor outcome of anxiety disorders in primary healthcare setups.

  17. Guidelines for reliability analysis of digital systems in PSA context. Phase 1 status report

    Energy Technology Data Exchange (ETDEWEB)

    Authen, S.; Larsson, J. (Risk Pilot AB, Stockholm (Sweden)); Bjoerkman, K.; Holmberg, J.-E. (VTT, Helsingfors (Finland))

    2010-12-15

    Digital protection and control systems are appearing as upgrades in older nuclear power plants (NPPs) and are commonplace in new NPPs. To assess the risk of NPP operation and to determine the risk impact of digital system upgrades on NPPs, quantitative reliability models are needed for digital systems. Due to the many unique attributes of these systems, challenges exist in systems analysis, modeling and in data collection. Currently there is no consensus on reliability analysis approaches. Traditional methods have clearly limitations, but more dynamic approaches are still in trial stage and can be difficult to apply in full scale probabilistic safety assessments (PSA). The number of PSAs worldwide including reliability models of digital I and C systems are few. A comparison of Nordic experiences and a literature review on main international references have been performed in this pre-study project. The study shows a wide range of approaches, and also indicates that no state-of-the-art currently exists. The study shows areas where the different PSAs agree and gives the basis for development of a common taxonomy for reliability analysis of digital systems. It is still an open matter whether software reliability needs to be explicitly modelled in the PSA. The most important issue concerning software reliability is proper descriptions of the impact that software-based systems has on the dependence between the safety functions and the structure of accident sequences. In general the conventional fault tree approach seems to be sufficient for modelling reactor protection system kind of functions. The following focus areas have been identified for further activities: 1. Common taxonomy of hardware and software failure modes of digital components for common use 2. Guidelines regarding level of detail in system analysis and screening of components, failure modes and dependencies 3. Approach for modelling of CCF between components (including software). (Author)

  18. Assessing the effectiveness of the Functional Movement Screen (FMS™) in predicting non-contact injury rates in soccer players.

    Science.gov (United States)

    Smith, Paul D; Hanlon, Michael

    2016-12-07

    This study assessed if the Functional Movement Screen (FMS™) can accurately predict non-contact injury in adult soccer players when normalizing non-contact injury occurrence against match exposure levels. Senior male players (n=89) from five League of Ireland semi-professional clubs participated in the study (mean age=23.2 ± 4.4 years; mean height=179.5 ± 6.6 cm; mean body mass=77.5 ± 7.8 kg). Participants performed the FMS™ during preseason and their injury occurrence rates and match minutes were tracked throughout one season. In total, 66 non-contact injuries were recorded. No significant difference was found in FMS™ composite scores between players receiving non-contact injuries and players not suffering a non-contact injury (p=0.96). There was no significant difference in exposure-normalized non-contact injury incidence between those scoring 14 or below and those scoring above 14 on the FMS™ (0.36 vs. 0.29 non-contact injuries per player per 1000 match minutes). Players scoring 14 or below on the FMS™ had an odds ratio of 0.63 (p=0.45; CI 95%=0.19- 2.07) of receiving a non contact injury. Despite previous research showing links between low FMS™ composite scores and subsequent injury, these results suggest the FMS™ cannot accurately predict a male soccer player's likelihood of receiving a non-contact injury and that a lower FMS™ composite score does not significantly increase their non-contact injury incidence rate per 1000 match minutes. Caution should therefore be used when employing the FMS™ as a predictor of non-contact injury, and pain prevalence during the FMS™, previous injuries, and training/match exposure levels should also be taken into account.

  19. Does preoperative breast MRI significantly impact on initial surgical procedure and re-operation rates in patients with screen-detected invasive lobular carcinoma?

    Science.gov (United States)

    Sinclair, K; Sakellariou, S; Dawson, N; Litherland, J

    2016-06-01

    To investigate whether magnetic resonance imaging (MRI) changes the management of patients with screen-detected invasive lobular carcinoma (ILC). A retrospective, controlled, single-centre analysis of 138 cases of screen-detected ILC was performed. All patients were assessed by a single multidisciplinary team as to whether preoperative MRI altered the initial management decision or reduced re-operation rates. Forty-three percent of patients had preoperative MRI. MRI guided surgical management in 40.7% patients. Primary mastectomy rates were not significantly different between the MRI and non-MRI groups (32% and 30% respectively, p=0.71). The MRI group had a lower secondary surgery rate (6.8% versus 15.2%); however, the results did not reach statistical significance, and there were no unnecessary mastectomies. MRI can be used appropriately to guide primary surgery in screen-detected ILC cases and affects the initial management decision in 40.7% of patients. It does not significantly affect the overall mastectomy rate or re-operation rates, but reduces the likelihood of the latter. As a result of this review, the authors' local policy for the use of MRI in screen-detected ILC patients has been modified. For patients undergoing mastectomy for ILC, MRI is no longer performed routinely to search for contralateral malignancy as this has no proven added benefit. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  20. Association between PSA kinetics and cancer-specific mortality in patients with localised prostate cancer

    DEFF Research Database (Denmark)

    Thomsen, Frederik Birkebæk; Brasso, Klaus; Berg, Kasper Drimer

    2016-01-01

    BACKGROUND: The prognostic value of prostate-specific antigen (PSA) kinetics in untreated prostate cancer (PCa) patients is debatable. We investigated the association between PSA doubling time (PSAdt), PSA velocity (PSAvel) and PSAvel risk count (PSAvRC) and PCa mortality in a cohort of patients...... were included of which 116, 76 and 71 had a PSA at consent ≤10, 10.1-25, and >25 ng/ml, respectively. Median follow-up was 13.6 years. For patients with PSA at consent between 10.1 and 25 ng/ml, the 13-year risks of PCa mortality were associated with PSA kinetics: PSAdt ≤3 years: 62.0% versus PSAdt >3...... years: 16.3% (Gray's test: P associated with changes of 13-year risks of PCa...

  1. Inhibition of pneumococcal adherence to human nasopharyngeal epithelial cells by anti-PsaA antibodies.

    Science.gov (United States)

    Romero-Steiner, Sandra; Pilishvili, Tamar; Sampson, Jacquelyn S; Johnson, Scott E; Stinson, Annie; Carlone, George M; Ades, Edwin W

    2003-03-01

    The role of pneumococcal (Pnc) surface adhesin A (PsaA) in the adherence of Streptococcus pneumoniae (pneumococcus) to host cells is not well defined. We examined the effect of anti-PsaA antibodies in an inhibition of adherence assay using Detroit 562 nasopharyngeal human epithelial cells. Rabbit polyclonal (Pab) anti-recombinant PsaA (rPsaA) sera, a purified mouse monoclonal antibody (MAb) (MAb 6F62G8E12), and 22 healthy adult sera with known anti-PsaA IgG levels (obtained by enzyme-linked immunosorbent assay) were evaluated for their abilities to inhibit Pnc adherence to confluent monolayers (measured as percent reduction in CFU counts compared to those of uninhibited controls). Pnc adherence was dependent on capsular phenotype (no or low adherence for opaque strains). With an inoculum of 10(4) to 10(5) bacteria/well, the mean +/- standard deviation count in controls was 163 +/- 32 CFU/well for transparent strains. Low adherence was observed for a PsaA-minus mutant even at higher inoculum doses. Mean percent inhibitions of adherence with Pab and MAb were 54 and 50%, respectively. Adult sera showed inhibition in a dose-response fashion with a range of 98 to 8%, depending on the serum anti-PsaA antibody concentration. Absorption of Pab with rPsaA restored Pnc adherence to control levels. Absorption of sera with a PsaA-minus mutant did not result in a significant decrease (P >0.05) of inhibition of adherence activity. Additionally, nearly 100% of Pnc adherence was inhibited by lipidated rPsaA at 2.5 micro g/ml. Our data support the argument that PsaA is an adhesin that mediates Pnc adherence to human nasopharyngeal cells. This functional assay may be useful in evaluating antibodies elicited in response to PsaA vaccination.

  2. Race-specific impact of natural history, mammography screening, and adjuvant treatment on breast cancer mortality rates in the United States

    NARCIS (Netherlands)

    N.T. van Ravesteyn (Nicolien); C.B. Schechter (Clyde); A.M. Near (Aimee); E.A.M. Heijnsdijk (Eveline); M.A. Stoto (Michael); G. Draisma (Gerrit); H.J. de Koning (Harry); J.S. Mandelblatt (Jeanne)

    2011-01-01

    textabstractBackground: U.S. Black women have higher breast cancer mortality rates than White women despite lower incidence. The aim of this study is to investigate how much of the mortality disparity can be attributed to racial differences in natural history, uptake of mammography screening, and

  3. The Planetary Science Archive (PSA): Exploration and discovery of scientific datasets from ESA's planetary missions

    Science.gov (United States)

    Vallat, C.; Besse, S.; Barbarisi, I.; Arviset, C.; De Marchi, G.; Barthelemy, M.; Coia, D.; Costa, M.; Docasal, R.; Fraga, D.; Heather, D. J.; Lim, T.; Macfarlane, A.; Martinez, S.; Rios, C.; Vallejo, F.; Said, J.

    2017-09-01

    The Planetary Science Archive (PSA) is the European Space Agency's (ESA) repository of science data from all planetary science and exploration missions. The PSA provides access to scientific datasets through various interfaces at http://psa.esa.int. All datasets are scientifically peer-reviewed by independent scientists, and are compliant with the Planetary Data System (PDS) standards. The PSA has started to implement a number of significant improvements, mostly driven by the evolution of the PDS standards, and the growing need for better interfaces and advanced applications to support science exploitation.

  4. [Clinicopathologic and biological correlations (PSA-PAP) in pathology of the prostate. Apropos of 150 cases].

    Science.gov (United States)

    Amiel, J; Chevallier, D; Peyrottes, A; Benoliel, J; Toubol, J

    1990-01-01

    On the basis of 150 patients (16 controls with no disease of the prostate, 96 cases of benign prostatic hypertrophy (BPH) and 38 cases of carcinoma of the prostate (CP)), the authors intended to answer 3 questions: How can the borderline values of PSA in BPH be interpreted? Is there a correlation between the Gleason and PSA values in carcinomas? Should the simultaneous measurements of PSA and PAP be continued? All patients were examined with a rectal touch, transrectal echography (TRE) and PAS and PAP assays. All CP were examined with bone radionuclide scanning (BR). The correlation coefficient being 0.391 (p 0.001), the PSA value and prostatic weight can be regarded as linearly correlated in BPH (5 g BPH = 1 ng/ml PSA). This lower value of PSA is linked with the increase produced by TRE in the assessment of prostatic weight. On the other hand, the authors did no observe a correlation between the PSA and the Glisson grade in carcinomas with negative BR. Lastly, the sensitivity of PSA is noticeably higher than that of PAP (75% vs. 50%), and no false negative finding with PSA was corrected by PAP measurements.

  5. Analytic expressions for the construction of a fire event PSA model

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Dae Il; Kim, Kil Yoo; Kim, Dong San; Hwang, Mee Jeong; Yang, Joon Eon [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    In this study, the changing process of an internal event PSA model to a fire event PSA model is analytically presented and discussed. Many fire PSA models have fire induced initiating event fault trees not shown in an internal event PSA model. Fire-induced initiating fault tree models are developed for addressing multiple initiating event issues. A single fire event within a fire compartment or fire scenario can cause multiple initiating events. As an example, a fire in a turbine building area can cause a loss of the main feed-water and loss of off-site power initiating events. Up to now, there has been no analytic study on the construction of a fire event PSA model using an internal event PSA model with fault trees of initiating events. In this paper, the changing process of an internal event PSA model to a fire event PSA model was analytically presented and discussed. This study results show that additional cutsets can be obtained if the fault trees of initiating events for a fire event PSA model are not exactly developed.

  6. Development of a Base Model for the New Fire PSA Training

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kilyoo; Kang, Daeil [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kim, Wee Kyong; Do, Kyu Sik [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2013-05-15

    US NRC/EPRI issued a new fire PSA method represented by NUREG/CR 6850, and have been training many operators and inspectors to widely spread the new method. However, there is a limitation in time and efficiency for many foreigners, who generally have communication problem, to participate in the EPRI/NRC training to learn the new method. Since it is about time to introduce the new fire PSA method as a regulatory requirement for the fire protection in Korea, a simple and easy-understandable base model for the fire PSA training is required, and KAERI-KINS is jointly preparing the base model for the new fire PSA training. This paper describes how the base model is developed. Using an imaginary simple NPP, a base model of fire PSA following the new fire PSA method was developed in two ways from the internal PSA model. Since we have the base model and know the process of making the fire PSA model, the training for the new fire PSA method can be in detail performed in Korea.

  7. Updating the Psoriatic Arthritis (PsA) Core Domain Set: A Report from the PsA Workshop at OMERACT 2016.

    Science.gov (United States)

    Orbai, Ana-Maria; de Wit, Maarten; Mease, Philip J; Callis Duffin, Kristina; Elmamoun, Musaab; Tillett, William; Campbell, Willemina; FitzGerald, Oliver; Gladman, Dafna D; Goel, Niti; Gossec, Laure; Hoejgaard, Pil; Leung, Ying Ying; Lindsay, Chris; Strand, Vibeke; van der Heijde, Désirée M; Shea, Bev; Christensen, Robin; Coates, Laura; Eder, Lihi; McHugh, Neil; Kalyoncu, Umut; Steinkoenig, Ingrid; Ogdie, Alexis

    2017-10-01

    To include the patient perspective in accordance with the Outcome Measures in Rheumatology (OMERACT) Filter 2.0 in the updated Psoriatic Arthritis (PsA) Core Domain Set for randomized controlled trials (RCT) and longitudinal observational studies (LOS). At OMERACT 2016, research conducted to update the PsA Core Domain Set was presented and discussed in breakout groups. The updated PsA Core Domain Set was voted on and endorsed by OMERACT participants. We conducted a systematic literature review of domains measured in PsA RCT and LOS, and identified 24 domains. We conducted 24 focus groups with 130 patients from 7 countries representing 5 continents to identify patient domains. We achieved consensus through 2 rounds of separate surveys with 50 patients and 75 physicians, and a nominal group technique meeting with 12 patients and 12 physicians. We conducted a workshop and breakout groups at OMERACT 2016 in which findings were presented and discussed. The updated PsA Core Domain Set endorsed with 90% agreement by OMERACT 2016 participants included musculoskeletal disease activity, skin disease activity, fatigue, pain, patient's global assessment, physical function, health-related quality of life, and systemic inflammation, which were recommended for all RCT and LOS. These were important, but not required in all RCT and LOS: economic cost, emotional well-being, participation, and structural damage. Independence, sleep, stiffness, and treatment burden were on the research agenda. The updated PsA Core Domain Set was endorsed at OMERACT 2016. Next steps for the PsA working group include evaluation of PsA outcome measures and development of a PsA Core Outcome Measurement Set.

  8. Physician–Patient Discussions of Controversial Cancer Screening Tests

    Science.gov (United States)

    Dunn, Andrew S.; Shridharani, Kanan V.; Lou, Wendy; Bernstein, Jeffrey; Horowitz, Carol R.

    2016-01-01

    Background Screening mammography for younger women and prostate-specific antigen (PSA) measurement have controversial benefits and known potential adverse consequences. While providing informed consent and eliciting patient preference have been advocated for these tests, little is known about how often these discussions take place or about barriers to these discussions. Methods We administered a survey to medical house staff and attending physicians practicing primary care. The survey examined physicians’ likelihood of discussing screening mammography and PSA testing, and factors influencing the frequency and quality of these discussions. Results For the three scenarios, 16% to 34% of physicians stated that they do not discuss the screening tests. The likelihood of having a discussion was significantly associated with house staff physicians’ belief that PSA screening is advantageous; house staff and attending physicians’ intention to order a PSA test, and attending physicians’ intention to order a mammogram; and a controversial indication for screening. The most commonly identified barriers to discussions were lack of time, the complexity of the topic, and a language barrier. Conclusions Physicians report they often do not discuss cancer screening tests with their patients. Our finding that physicians’ beliefs and intention to order the tests, and extraneous factors such as time constraints and a language barrier, are associated with discussions indicates that some patients may be inappropriately denied the opportunity to choose whether to screen for breast and prostate cancer. PMID:11165455

  9. Low positivity rate after systematic screening for Trichomonas vaginalis in three patient cohorts from general practitioners, STI clinic and a national population-based chlamydia screening study

    NARCIS (Netherlands)

    Geelen, Tanja H.; Hoebe, Christian J. P. A.; Dirks, Anne; Dukers-Muijrers, Nicole H. T. M.; van Bergen, Jan E. A. M.; Wolffs, Petra F. G.

    2013-01-01

    The goal of this multi-cohort study is to investigate the positivity rate of Trichomonas vaginalis (TV) among three distinct Dutch patient populations and its relation with Chlamydia trachomatis (CT) positivity. Few studies have been performed in Europe where TV positivity rate seems to be low.

  10. Serum complexed and free prostate-specific antigen (PSA) for the diagnosis of the polycystic ovarian syndrome (PCOS).

    Science.gov (United States)

    Diamandis, Eleftherios P; Stanczyk, Frank Z; Wheeler, Sarah; Mathew, Anu; Stengelin, Martin; Nikolenko, Galina; Glezer, Eli N; Brown, Marshall D; Zheng, Yingye; Chen, Yen-Hao; Wu, Hsiao-Li; Azziz, Ricardo

    2017-10-26

    Polycystic ovarian syndrome (PCOS) is a common cause of reproductive and metabolic dysfunction. We hypothesized that serum prostate-specific antigen (PSA) may constitute a new biomarker for hyperandrogenism in PCOS. We conducted a cross-sectional study of 45 women with PCOS and 40 controls. Serum from these women was analyzed for androgenic steroids and for complexed PSA (cPSA) and free PSA (fPSA) with a novel fifth- generation assay with a sensitivity of ~10 fg/mL for cPSA and 140 fg/mL for fPSA. cPSA and fPSA levels were about three times higher in PCOS compared to controls. However, in PCOS, cPSA and fPSA did not differ according to waist-to-hip ratio, Ferriman-Gallwey score, or degree of hyperandrogenemia or oligo-ovulation. In PCOS and control women, serum cPSA and fPSA levels were highly correlated with each other, and with free and total testosterone levels, but not with other hormones. Adjusting for age, body mass index (BMI) and race, cPSA was significantly associated with PCOS, with an odds ratio (OR) of 5.67 (95% confidence interval [CI]: 1.86, 22.0). The OR of PCOS for fPSA was 7.04 (95% CI: 1.65, 40.4). A multivariate model that included age, BMI, race and cPSA yielded an area-under-the-receiver-operating-characteristic curve of 0.89. Serum cPSA and fPSA are novel biomarkers for hyperandrogenism in PCOS and may have value for disease diagnosis.

  11. Prostate cancer screening in Primary Health Care: the current state of affairs.

    Science.gov (United States)

    Ranasinghe, Weranja Kb; Kim, Simon P; Papa, Nathan P; Sengupta, Shomik; Frydenberg, Mark; Bolton, Damien; Pond, Dimity; Ried, Karin; Marshall, Melanie J; Persad, Raj; Lawrentschuk, Nathan

    2015-01-01

    This study aims to examine the current practice of General practitioners (GPs)/primary care physicians in opportunistic screening for prostate cancer (PC) by digital rectal examination(DRE) and Prostate Specific Antigen(PSA) testing and identify any difference in screening practice. Printed copies and/or electronic versions of a survey was distributed amongst 438 GPs throughout Australia in 2012. Statistical analyses (Wilcoxon rank-sum test, Fisher's exact test or Pearson chi-square test)were performed by outcomes and GP characteristics.There were a total of 149 responses received (34%), with similar gender distribution in rural and metropolitan settings. 74% GPs believed PSA testing was at least 'somewhat effective' in reducing PC mortality with annual PSA screening being conducted by more GPs in the metropolitan setting compared to the rural GPs (35% vs 18.4%), while 25% of rural GPs would not advocate routine PSA screening. When examining the concordance between DRE and PSA testing by gender of GP, the male GPs reported performing PSA testing more frequently than DRE in patients between ages 40 to 69 (p = 0.011). Urology Society guidelines (77.2%) and College of GPs (73.2%) recommendations for PC screening were thought to be at least 'somewhat useful'. Although reference ranges for PSA tests were felt to be useful, the majority (65.8%) found it easier to refer to an urologist due to the disagreements in guidelines. In conclusion, the current guidelines for PSA screening appear to cause more confusion due to their conflicting advice, leaving GPs to formulate their own practice methods, calling for an urgent need for uniform collaborative guidelines.

  12. Effects of facilitated team meetings and learning collaboratives on colorectal cancer screening rates in primary care practices: a cluster randomized trial.

    Science.gov (United States)

    Shaw, Eric K; Ohman-Strickland, Pamela A; Piasecki, Alicja; Hudson, Shawna V; Ferrante, Jeanne M; McDaniel, Reuben R; Nutting, Paul A; Crabtree, Benjamin F

    2013-01-01

    The purpose of this study was to evaluate a primary care practice-based quality improvement (QI) intervention aimed at improving colorectal cancer screening rates. The Supporting Colorectal Cancer Outcomes through Participatory Enhancements (SCOPE) study was a cluster randomized trial of New Jersey primary care practices. On-site facilitation and learning collaboratives were used to engage multiple stakeholders throughout the change process to identify and implement strategies to enhance colorectal cancer screening. Practices were analyzed using quantitative (medical records, surveys) and qualitative data (observations, interviews, and audio recordings) at baseline and a 12-month follow-up. Comparing intervention and control arms of the 23 participating practices did not yield statistically significant improvements in patients' colorectal cancer screening rates. Qualitative analyses provide insights into practices' QI implementation, including associations between how well leaders fostered team development and the extent to which team members felt psychologically safe. Successful QI implementation did not always translate into improved screening rates. Although single-target, incremental QI interventions can be effective, practice transformation requires enhanced organizational learning and change capacities. The SCOPE model of QI may not be an optimal strategy if short-term guideline concordant numerical gains are the goal. Advancing the knowledge base of QI interventions requires future reports to address how and why QI interventions work rather than simply measuring whether they work.

  13. Histopathological findings in extended prostate biopsy with PSA ≤ 4 ng/mL

    Directory of Open Access Journals (Sweden)

    Katia R. Leite

    2008-06-01

    Full Text Available OBJECTIVE: Cancer detection has been reported in up to 27% of patients when lowering the PSA cutoff to 2.5 ng/mL. Although this practice could increase the number of biopsies performed, it also could lead to more frequent detection of significant prostate cancers at an organ-confined stage and/or a less aggressive state. This study describes the incidence of malignancy and tumor characteristics in extended prostate biopsies with PSA ≤ 4 ng/mL. MATERIALS AND METHODS: Prostate biopsies from 1081 patients where examined, 275 (25.4% patients had PSA level ≤ 4 ng/mL. RESULTS: Cancer was diagnosed in 32.0% and 35.7% of patients with PSA ≤ 4 ng/mL and > 4 ng/mL, respectively (p = 0.906. The median Gleason score was 7 independent of PSA > or ≤ 4 ng/mL (p = 0.078. The median number of cores positive for tumor was 4 and 3, respectively, for PSA > 4 ng/mL and PSA ≤ 4 ng/mL (p = 0.627. There was a difference in the total percent of tumors involving all cores, 11% and 7% for PSA > or ≤ 4 ng/mL (p = 0.042. Fifty-six patients underwent radical prostatectomy, 12 had PSA ≤ 4 ng/mL. In both groups, a diagnosis of cancer was accurate with no differences in Gleason score, tumor volume or staging for both groups. CONCLUSION: When PSA is below 4 ng/mL, cancer is detected in a proportion equal to the proportion diagnosed with a PSA > 4 ng/mL, and tumor characteristics are similar between the two groups. Only clinically significant tumors were diagnosed following radical prostatectomy.

  14. Survey of prenatal screening policies in Europe for structural malformations and chromosome anomalies, and their impact on detection and termination rates for neural tube defects and Down's syndrome

    DEFF Research Database (Denmark)

    Boyd, P A; Devigan, C; Khoshnood, B

    2008-01-01

    OBJECTIVE: To 'map' the current (2004) state of prenatal screening in Europe. DESIGN: (i) Survey of country policies and (ii) analysis of data from EUROCAT (European Surveillance of Congenital Anomalies) population-based congenital anomaly registers. SETTING: Europe. POPULATION: Survey of prenatal...... tube defects (NTDs) using the EUROCAT database. MAIN OUTCOME MEASURES: Existence of national prenatal screening policies, legal gestation limit for TOPFA, prenatal detection and termination rates for Down's syndrome and NTD. RESULTS: Ten of the 18 countries had a national country-wide policy for Down...... cases. Six of the 18 countries had a legal gestational age limit for TOPFA, and in two countries, termination of pregnancy was illegal at any gestation. CONCLUSIONS: There are large differences in screening policies between countries in Europe. These, as well as organisational and cultural factors...

  15. The effectiveness of the motion picture association of America's rating system in screening explicit violence and sex in top-ranked movies from 1950 to 2006.

    Science.gov (United States)

    Nalkur, Priya G; Jamieson, Patrick E; Romer, Daniel

    2010-11-01

    Youth exposure to explicit film violence and sex is linked to adverse health outcomes and is a serious public health concern. The Motion Picture Association of America's (MPAA's) rating system's effectiveness in reducing youth exposure to harmful content has been questioned. To determine the MPAA's rating system's effectiveness in screening explicit violence and sex since the system's initiation (1968) and the introduction of the PG-13 category (1984). Also, to examine evidence of less restrictive ratings over time ("ratings creep"). Top-grossing movies from 1950 to 2006 (N = 855) were coded for explicitness of violent and sexual content. Trends in rating assignments and in the content of different rating categories since 1968 were assessed. The explicitness of violent and sexual content significantly increased following the rating system's initiation. The system did not differentiate violent content as well as sexual content, and ratings creep was only evident for violent films. Explicit violence in R-rated films increased, while films that would previously have been rated R were increasingly assigned to PG-13. This pattern was not evident for sex; only R-rated films exhibited higher levels of explicit sex compared to preratings period. While relatively effective for screening explicit sex, the rating system has allowed increasingly violent content into PG-13 films, thereby increasing youth access to more harmful content. Assignment of films in the current rating system should be more sensitive to the link between violent media exposure and youth violence. Copyright © 2010 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  16. Altered glycosylation pattern allows the distinction between prostate-specific antigen (PSA) from normal and tumor origins.

    Science.gov (United States)

    Peracaula, Rosa; Tabarés, Glòria; Royle, Louise; Harvey, David J; Dwek, Raymond A; Rudd, Pauline M; de Llorens, Rafael

    2003-06-01

    Prostate-specific antigen (PSA) is a glycoprotein secreted by prostate epithelial cells. PSA is currently used as a marker of prostate carcinoma because high levels of PSA are indicative of a tumor situation. However, PSA tests still suffer from a lack of specificity to distinguish between benign prostate hyperplasia and prostate cancer. To determine whether PSA glycosylation could provide a means of differentiating between PSA from normal and tumor origins, N-glycan characterization of PSA from seminal fluid and prostate cancer cells (LNCaP cell line) by sequencing analysis and mass spectrometry was carried out. Glycans from normal PSA (that correspond to low and high pI PSA fractions) were sialylated biantennary complex structures, half of them being disialylated in the low pI PSA fraction and mostly monosialylated in the high pI PSA. PSA from LNCaP cells was purified to homogeneity, and its glycan analysis showed a significantly different pattern, especially in the outer ends of the biantennary complex structures. In contrast to normal PSA glycans, which were sialylated, LNCaP PSA oligosaccharides were all neutral and contained a higher fucose content. In 10-15% of the structures fucose was linked alpha1-2 to galactose, forming the H2 epitope absent in normal PSA. GalNAc was increased in LNCaP glycans to 65%, whereas in normal PSA it was only present in 25% of the structures. These carbohydrate differences allow a distinction to be made between PSA from normal and tumor origins and suggest a valuable biochemical tool for diagnosis and follow-up purposes.

  17. Review of UCN 5,6 Fire PSA Model based on ANS Fire PRA Standard

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Joon Eon; Lee, Yoon Hwan

    2006-12-15

    Recently, under the de-regulation environment, nuclear industry has attempted various approaches to improve the economics of Nuclear Power Plants (NPP). This approach uses the fire risk and performance information to manage the resources effectively and efficiently that are used in the operation of NPP. In fire risk informed/performance-based decision/operation, fire PSA quality is one of the most important things. The nuclear industry and regulatory body of U.S.A have developed a measure to evaluate the quality of fire PSA. ANS (American Nuclear Society) has developed a guidance called 'ANS Fire PRA Methodology Standard'. However, in Korea, there have been no attempts to evaluate the quality of fire PSA model itself. Therefore, we cannot be sure about the quality of fire PSA whether or not the present fire PSA model can be used for the risk-informed applications such as mentioned above. We can say that the evaluation of fire PSA model quality is the basis for the fire risk informed/performance-based decision/operation. In this report, we have evaluated the quality of fire PSA model for Ulchin 5 and 6 units based on the ANS Fire PRA Standard. We, also, have derived what items are to be improved to upgrade the quality of fire PSA model and how it can be improved. This report can be used as the base of the fire risk informed/performance-based decision/operation work in Korea.

  18. The role of the percentage free PSA in the diagnosis of prostate ...

    African Journals Online (AJOL)

    Subjects and methods: A total 169 consecutive patients with tPSA of 4–10 ng/ml with non-suspicious findings on digital rectal examination (DRE) had a transrectal ultrasound (TRUS) guided 10-core prostate biopsy. The technique of PSA analysis was the Access hybritech assay technique using the Beckman's Access ...

  19. Improved first-trimester Down syndrome screening performance by lowering the false-positive rate: a prospective study of 9941 low-risk women

    DEFF Research Database (Denmark)

    Wøjdemann, K R; Shalmi, A C; Christiansen, M

    2005-01-01

    OBJECTIVE: To determine the performance of screening for Down syndrome (DS) and other major chromosomal abnormalities using nuchal translucency (NT), free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in a prospective study of a non-selected popul......OBJECTIVE: To determine the performance of screening for Down syndrome (DS) and other major chromosomal abnormalities using nuchal translucency (NT), free beta-human chorionic gonadotropin (beta-hCG) and pregnancy-associated plasma protein-A (PAPP-A) in a prospective study of a non......-selected population. METHODS: Of 9941 women with an early ultrasound examination, NT was measured in 8622 singleton pregnancies with a gestational age between 10 + 3 and 13 + 6 weeks. beta-hCG and PAPP-A were analyzed in 6441 cases. Detection rates (DR) and false-positive rates (FPR) for the NT screening, the double...... test (beta-hCG and PAPP-A) and the combined test (NT and the double test) were calculated using a 1 : 250 cut-off. RESULTS: NT could be measured in 97.5% of cases. The DR for DS with NT screening alone was 75% with a FPR of only 1.8%. The double test detected 73% and the combined test 91%, for FPRs...

  20. Self-assembled particulate PsaA as vaccine against Streptococcus pneumoniae infection

    Directory of Open Access Journals (Sweden)

    Majela González-Miro

    2017-04-01

    Full Text Available Streptococcus pneumoniae is a human pathogen responsible for the majority of childhood pneumonia and media otitis cases worldwide. The diversity of its capsular polysaccharides (CPS results in more than 91 serotypes of which at least 23 are virulent. Various CPS conjugated to immunogenic carrier proteins are currently licensed and provide protection against the infection caused by the respective serotypes but not against new and emerging virulent serotypes. In this study, we considered the conserved protein antigen PsaA, the pneumococcal surface adhesin A, in order to overcome the limitations of CPS antigens. The PsaA was translationally fused to a polyhydroxybutyrate (PHB synthase which mediated production of PsaA displayed on PHB inclusions in recombinant Escherichia coli. This suggested that the PsaA fusion to the PHB synthase did not interfere with PHB synthase activity and its ability to mediate formation of nano-sized inclusions composed of a PHB core surrounded by the PHB synthase fused to PsaA. Isolated PHB beads showed a negative surface charge. Transmission electron microscopy analysis suggested that the PsaA fusion to the PHB synthase reduced the size of PHB beads from about 500 nm to 100 nm. The integrity and antigenicity of the fusion protein attached to isolated PHB beads was confirmed by SDS-PAGE, tryptic peptide fingerprinting analysis using MALDI-TOF-MS/MS and immunoblotting using a monoclonal anti-PsaA antibody. Mice immunized with PsaA displaying PHB beads produced high and specific IgG levels dominated by IgG1 isotype. While IgG1 titer were similar between soluble and insoluble PsaA, the IgG2 titers were strongly increased upon vaccination with insoluble PsaA i.e. PsaA displayed on PHB beads. Particulate PsaA-PHB beads elicited IgG antibodies recognizing PsaA in whole cell lysates of seven different serotypes of S. pneumoniae. This study suggested that PHB beads are suitable carriers for PsaA in order to induce a significant

  1. Trends in prostate cancer incidence and mortality before and after the introduction of PSA testing in the Slovak and Czech Republics.

    Science.gov (United States)

    Ondrusova, Martina; Ondrus, Dalibor; Karabinos, Juraj; Muzik, Jan; Kliment, Jan; Gulis, Gabriel

    2011-01-01

    As two neighboring countries in central Europe with national cancer registries, the Slovak (SR) and Czech Republics (CR) are countries with a medium global rate in the occurrence of prostate cancer. This paper analyzes the incidence of prostate cancer and mortality before and after the introduction of PSA testing in the two Republics and the possible reasons for any differences discovered and compares the results with selected regions and countries of the world. In the Slovak Republic, prostate cancer incidence (age-adjusted to the world standard population) has risen from 14.6/100,000 in 1968 (95% CI, ±1.5772) to 36.2/100,000 in 2005 (95% CI, ±2.0678). The estimated annual increase in the incidence during the period 1968-1991 (before nationwide PSA testing) was 0.421; from 1991 (when nationwide PSA testing began) to up to 2003 it was 0.941. Mortality rates grew from 7.3/100,000 in 1968 to 14.9/100,000 in 2005. In spite of the geographic proximity of the two countries, the increase in incidence occurred faster in the Czech than in the Slovak Republic, from 15.8/100,000 in 1977 (95% CI, ±0.9748) to 59.5/100,000 in 2005 (95% CI, ±1.7187). The estimated annual increase in incidence in the Czech Republic for the period of 1977-1991 was 0.581. From 1991 (when national PSA testing began) until 2003, it was 1.981. In the period before 1991, mortality rose more sharply in the Czech than in the Slovak Republic, whereas after the introduction of PSA testing mortality stabilized more quickly in the Czech than in the Slovak Republic. In the Slovak Republic, a significant reduction in mortality was observed after 2002 and has continued to the present and probably is not affected only by the results connected with the increase in PSA testing. The difference in the incidence and mortality of prostate cancer in the Slovak and the Czech Republics results from a difference in the intensity of PSA testing as well as from the introduction of complex, more effective treatment in

  2. Awareness of cancer screening during treatment of patients with renal failure: a physician survey in Turkey.

    Science.gov (United States)

    Uysal-Sonmez, Ozlem; Tanriverdi, Ozgur; Uyeturk, Ummugul; Budakoglu, Isil Irem; Kazancioglu, Rumeyza; Turker, Ibrahim; Budakoglu, Burcin; Yalcintas-Arslan, Ulku; Oksuzoglu, Berna

    2014-01-01

    Today, survival rate of patients with chronic renal failure/hemodialysis has increased so that chronic illnesses are more likely to occur. Cancer is the main cause of morbidity and mortality in such patients. In this study, physician attitudes were examined about cancer screening in patients with renal failure. This study was done by face to face questionnaire in the 27th National Nephrology Congress to determine if the physicians dealing with chronic renal failure, hemodialysis or renal transplanted patients, recommend cancer screening or not and the methods of screening for cervix, prostate, breast and colon cancer. One hundred and fifty six physicians were included in the survey. A total of 105 (67%) participants were male and the age of responders was 48 ± 9 years. About 29% were specialists in nephrology, 28% internal medicine, and 5% were other areas of expertise. Some 48% of participants were hemodialysis certified general practitioners. Patients were grouped as compensated chronic renal failure, hemodialysis or renal transplanted. Of the 156 responders, 128 (82%) physicians recommended breast cancer screening and the most recommended subgroup was hemodialysis patients (15%). The most preferred methods of screening were combinations of mammography, self breast examination and physician breast examination. 112 (72%) physicians recommended cervix cancer screening, and the most preferred method of screening was pap-smear. Colon cancer screening was recommended by 102 (65%) physicians and prostate screening by 109 (70%) physicians. The most preferred methods of screening were fecal occult blood test and PSA plus rectal digital test, respectively. It is not obvious whether cancer screening in renal failure patients is different from the rest of society. There is a variety of screening methods. An answer can be found to these questions as a result of studies by a common follow-up protocol and cooperation of nephrologists and oncologists.

  3. Multi-span transmission using phase and amplitude regeneration in PPLN-based PSA.

    Science.gov (United States)

    Umeki, T; Asobe, M; Takara, H; Miyamoto, Y; Takenouchi, H

    2013-07-29

    We demonstrated multi-span transmission using a periodically poled LiNbO(3) (PPLN) based phase sensitive amplifier (PSA). An in-line PSA with a carrier recovery and phase locking system is implemented as a repeater amplifier in a recirculating loop. We achieved a PSA gain as high as + 18 dB and a high external gain of + 12 dB for the in-line PSA as a black box. The impairments caused by phase noise resulting from fiber nonlinearity and intensity noise caused by the amplified spontaneous emission (ASE) of an optical amplifier are largely suppressed using the phase and amplitude regeneration capabilities of the PSA. The ultra long-haul transmission of a 28-Gb/s binary phase shift keying (BPSK) signal over 5400 km was achieved with phase and amplitude regeneration.

  4. EOP Improvement Proposal for SGTR based on The OPR PSA Update

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jin Hee; Cho, Jae Hyun; Kim, Dong San; Yang, Joon Eon [KAERI, Daejeon (Korea, Republic of)

    2016-05-15

    This updating process was also focused to enhance the PSA quality and to respect the as built and as operated conditions of target plants. For this purpose, the EOP(Emergency Operating Procedure) and AOP(Abnormal Operating Procedure) of target plant were reviewed in detail and various thermal hydraulic(T/H) analysis were also performed to analyze the realistic PSA accident sequence model. In this paper, the unreasonable point of SGTR (Steam Generator Tube Rupture) EOP based on PSA perspective was identified and the initial proposal for EOP change items from PSA insight was proposed. In this paper, the unreasonable point of SGTR EOP based on PSA perspective was identified and the EOP improvement items are proposed to enhance safety and operator's convenience for the target plant.

  5. Impact of a national beta-thalassemia carrier screening program on the birth rate of thalassemia major.

    Science.gov (United States)

    Chern, Jimmy P S; Lin, Kai-Hsin; Su, Yi-Ning; Lu, Meng-Yao; Jou, Shiann-Tarng; Lin, Dong-Tsamn; Wang, Shih-Chung; Lin, Kuo-Sin

    2006-01-01

    In Taiwan, the prevalence of beta-thalassemia trait is at least 1.1%. The Taiwan government initiated a National Screening Program in 1993. Herein we examine the differences before and after the initiation of this program. Data consisting of the total number of patients and the birth prevalence beta-thalassemia major were collected. Ninety-one patients with transfusion-dependent thalassemia treated in our hospitals were included for analysis. DNA analysis was performed for 86 patients. In Taiwan 361 patients exist. The birth prevalence of per 100,000 births was 5.6% in 1994 and declined to 1.21 in 2002. Fourteen patients were born after the program's initiation. DNA analysis of them revealed a new mutation (IVS-1-5 (G-C)), which was introduced through an inter-racial marriage. Otherwise, the remainder was the common beta-thalassemia mutations found in Taiwan. Despite how successful the National Screening Program is, a few doctors still failed to detect parents at risk. In addition, we are concerned about the emerging problem of the increase of interracial marriages where parents may not have appropriate screening. Hence, postgraduate education programs for physicians, health education for the general population, and timely screening of inter-racial marriage should become a priority.

  6. Prenatal Sickle Cell Screening Education Effect on the Follow-up Rates of Infants with Sickle Cell Trait.

    Science.gov (United States)

    Yang, Yih-Ming; Andrews, Susan; Peterson, Rose; Shah, Arvind; Cepeda, Manuel

    2000-01-01

    Assesses the effect of prenatal education about newborn sickle cell screening on parents' compliance with the follow-up for infants with sickle cell trait. Results show that parents whose prenatal education included sickle cell hemoglobinopathy information retained significantly more of the information given during the post-natal education than…

  7. Lessons learnt from PSA for new and advanced reactors in Russia

    Energy Technology Data Exchange (ETDEWEB)

    Tokmachev, G.; Morozov, V. [JSC ' ' Atomenergoproekt' ' , Moscow (Russian Federation)

    2011-11-15

    Customer requirements to probabilistic safety targets are usually stronger than existing Regulatory or IAEA ones. It appears that industry takes the lead over regulation in this case and forces the designer to find and implement appropriate means to enhance safety, which sometimes have no reference to practical experience. On the other hand, regulatory documents and the existing PSA methodology are mainly oriented to operating plants. This creates problems when developing a PSA as well as performing regulatory reviews. The scope of the PSA may be different depending on a design stage such as the development conceptual, basic or detailed design. In addition, the base case PSA is usually performed for NPP in design. However, a customer may require additional PSA applications to consider, for instance, risk monitoring. In this case the scope of the PSA should be extended to implement special attributes of the application needed that often requires specific information not available at the design stage. Lack of design information affecting PSA development may be associated with incompleteness of the design that is typical for interim design stages and communication problems caused by the involvement of many different companies in the deign activity. To deal with this issue bounding technologies and the iterative PSA development are used. However this sometimes contradicts to the ''best estimate'' approach recommended by regulatory guides. PSA development for advanced NPPs has raised some issues originated from unknown new components, processes and technologies incorporated into the design of an advanced plant. The paper addresses some issues resolved while carrying out PSAs for advanced NPPs. Some PSA results for new advanced VVER plants under construction and the first lessons learnt from the Fukushima accident are also discussed. (orig.)

  8. Postoperative monitoring of prostate-specific antigen (PSA after treatment with high-intensive focused ultrasound (HIFU

    Directory of Open Access Journals (Sweden)

    Blyumberg B.I.

    2012-12-01

    Full Text Available Research objective: to estimate efficiency of treatment of prostate cancer using high-intensive focused ultrasound on the basis of laboratory analysis of postoperative level prostate-specific antigen (PSA. Objects of research. Objects of research consisted of 110 patients treated in urological clinic of Hospital n.a. S. R. Mirotvortsev (Saratov State Medical University during the period February, 2009 — March, 2012. Patients took 110 sessions of primary operative treatment of prostate cancer by HIFU therapy method. Technique and research methods. Concentration of PSA in blood changed in all patients every 1,5 month within 6 months after operation, irrespective of its kind (including after repeated HIFU, further — after every 3 month till one year, and later on after 6 months. We were guided by references of the International Consensus, which considers PSA level more than 0,5 ng/ml in blood after 3 months of treatment to be unsatisfactory result. We also headed for PSA level before treatment and oncological risk degree. Results. Median nadir formed 0,5 ng/ml PSA by 3 months after treatment. Patients demonstrated different indicators of PSA dynamics depending on oncological risk, stage and hormonal therapy management. Patients with low oncological risk had initially lower PSA concentration, further PSA concentration reached nadir level faster. At patients with widespread forms of prostate cancer accurate dependence of PSA concentration according to prevalence of process was traced. Time of PSA nadir amount did not differ and was marked as 12-14 weeks on average. At patients received hormonal therapy, lower value of PSA nadir was marked. The conclusion. Monitoring of PSA concentration (PSA nadir by 3 months, dynamics of PSA concentration change is of great importance in early revealing of relapse after prostate HIFU therapy. High level of PSA nadir and PSA growth according to time period are important prognostic factors.

  9. Mass screening of prostate cancer in a Chinese population: the relationship between pathological features of prostate cancer and serum prostate specific antigen.

    Science.gov (United States)

    Gao, Hong-Wen; Li, Yu-Lin; Wu, Shan; Wang, Yi-Shu; Zhang, Hai-Feng; Pan, Yu-Zhuo; Zhang, Ling; Tateno, Hiroo; Sato, Ikuro; Kuwahara, Masaaki; Zhao, Xue-Jian

    2005-06-01

    To investigate the pathological features of the prostate biopsy through mass screening for prostate cancer in a Chinese cohort and their association with serum prostate specific antigen (PSA). A total of 12027 Chinese men in Changchun were screened for prostate cancer by means of the serum total prostate specific antigen tPSA test (by Elisa assay). Transrectal ultrasound-guided systematic six-sextant biopsies were performed on those whose serum tPSA value was > 4.0 ng/mL and those who had obstructive symptoms (despite their tPSA value) and were subject to subsequent pathological analysis with the aid of the statistic software SPSS 10.0 (SPSS. Inc., Chicago. USA). Of the 12027 cases, 158 (including 137 patients whose serum tPSA values were 4.0 ng/mL and 21 patients [serum tPSA sextant biopsies was established (r = 0.406, P first to conduct mass screening for prostate cancer by testing for serum tPSA values and the first to investigate the pathological features of prostate cancer in a cohort of Chinese men. Our results reveal that the moderately differentiated carcinoma is the most common type of prostate cancer. This study also has shown that the serum tPSA value in prostate cancer is associated with the Gleason score and the size of tumor.

  10. High PSA anxiety and low health literacy skills: drivers of early use of salvage ADT among men with biochemically recurrent prostate cancer after radiotherapy?

    Science.gov (United States)

    Mahal, B A; Chen, M-H; Bennett, C L; Kattan, M W; Sartor, O; Stein, K; D'Amico, A V; Nguyen, P L

    2015-07-01

    Although commonly used, early initiation of salvage androgen deprivation therapy (ADT) has not been proven to enhance survival. We evaluated whether prostate-specific antigen (PSA) anxiety or health literacy are associated with use of early salvage ADT among men with recurrent prostate cancer after radiotherapy. The prospective Comprehensive, Observational, Multicenter, Prostate Adenocarcinoma Registry was used to study 375 men with biochemically recurrent prostate cancer after external beam radiation or brachytherapy. Multivariable logistic regression was used to determine whether PSA anxiety and health literacy are associated with salvage ADT as initial management after biochemical recurrence. Sixty-eight men (18.1%) received salvage ADT as initial management for PSA recurrence. Men with high PSA anxiety were twice as likely to receive salvage ADT compared with men who did not have high PSA anxiety on both univariable [28.8% versus 13.1%; odds ratio (OR) 2.15; 95% confidence interval (CI) 1.16-4.00; P = 0.015] and multivariable analysis [adjusted OR (AOR) 2.36; 95% CI 1.21-4.62; P = 0.012]. Furthermore, men who had higher levels of health literacy were nearly half as likely to undergo salvage ADT compared with men who had lower levels of health literacy on univariable analysis (15.2% versus 26.3%; OR 0.50; 95% CI 0.29-0.88; P = 0.016), with a trend toward this association on multivariable analysis (AOR 0.58; 95% CI 0.32-1.05; P = 0.07). Among men with PSA recurrence after radiotherapy, odds of use of salvage ADT were nearly twice as great among men with high PSA anxiety or low health literacy, suggesting that these men are receiving higher rates of unproven treatment. Given that early salvage ADT is costly, worsens quality of life, and has not been shown to improve survival, quality improvement strategies are needed for these individuals. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights

  11. Role of 18F-Choline PET/CT in guiding biopsy in patients with risen PSA levels and previous negative biopsy for prostate cancer.

    Science.gov (United States)

    Jiménez Londoño, G A; García Vicente, A M; Amo-Salas, M; Fúnez Mayorga, F; López Guerrero, M A; Talavera Rubio, M P; Gutierrez Martin, P; González García, B; de la Torre Pérez, J A; Soriano Castrejón, Á M

    To study 18F-Choline PET/CT in the diagnosis and biopsy guide of prostate cancer (pCa) in patients with persistently high prostate-specific antigen (PSA) and previous negative prostate biopsy. To compare the clinical risk factors and metabolic variables as predictors of malignancy. Patients with persistently elevated PSA in serum (total PSA >4ng/mL) and at least a previous negative or inconclusive biopsy were consecutively referred for a whole body 18F-Choline PET/CT. Patient age, PSA level, PSA doubling time (PSAdt) and PSA velocity (PSAvel) were obtained. PET images were visually (positive or negative) and semiquantitatively (SUVmax) reviewed. 18F-Choline uptake prostate patterns were defined as focal, multifocal, homogeneous or heterogeneous. Histology on biopsy using transrectal ultrasound-guided approach was the gold standard. Sensitivity (Se), specificity (Sp) and accuracy (Ac) of PET/CT for diagnosis of pCa were evaluated using per-patient and per-prostate lobe analysis. Receiver-operating-characteristic (ROC) curve analysis was used to assess the value of SUVmax to diagnose pCa. Correlation between PET/CT and biopsy results per-prostate lobe was assessed using the Chi-square test. Univariate and multivariate logistic regression analysis were applied to compare clinical risk factors and metabolic variables as predictors of malignancy. Thirty-six out of 43 patients with histologic confirmation were included. In 11 (30.5%) patients, pCa was diagnosed (Gleason score from 4 to 9). The mean values of patient age, PSA level, PSAdt and PSAvel were: 65.5 years, 15.6ng/ml, 28.1 months and 8.5ng/mL per year, respectively. Thirty-three patients had a positive PET/CT; 18 had a focal pattern, 7 multifocal, 4 homogeneous and 4 heterogeneous. Se, Sp and Ac of PET/CT were of 100%, 12% and 38% in the patient based analysis, and 87%, 29% and 14% in the prostate lobe based analysis, respectively. The ROC curve analysis of SUVmax showed an AUC of 0.568 (p=0.52). On a lobe

  12. Factors affecting recall rate and false positive fraction in breast cancer screening with breast tomosynthesis - A statistical approach.

    Science.gov (United States)

    Rosso, Aldana; Lång, Kristina; Petersson, Ingemar F; Zackrisson, Sophia

    2015-10-01

    In this study, we investigate which factors affect the false positive fraction (FPF) for digital breast tomosynthesis (DBT) compared to digital mammography (DM) in a screening population by using classification and regression trees (C&RT) and binary marginal generalized linear models. The data was obtained from the Malmö Breast Tomosynthesis Screening Trial, which aimed to compare the performance of DBT to DM in breast cancer screening. By using data from the first half of the study population (7500 women), a tree with the recall probability for different groups was calculated. The effect of age and breast density on the FPF was estimated using a binary marginal generalized linear model. Our results show that breast density and breast cancer were the main factors influencing recall. The FPF is mainly affected by breast density and increases with breast density for DBT and DM. In conclusion, the results obtained with C&RT are easy to interpret and similar to those obtained using binary marginal generalized linear models. The FPF is approximately 40% higher for DBT compared to DM for all breast density categories. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Is the upgrade rate of atypical ductal hyperplasia diagnosed by core needle biopsy of calcifications different for digital and film-screen mammography?

    Science.gov (United States)

    McLaughlin, Carol T; Neal, Colleen H; Helvie, Mark A

    2014-10-01

    The purpose of this study was to establish the upgrade rate of atypical ductal hyperplasia (ADH) diagnosed by stereotactic vacuum-assisted core needle biopsy for calcifications detected by digital mammography as compared with film-screen mammography. A retrospective record search identified 101 cases of ADH. Criteria included women with calcifications biopsied using stereotactic vacuum-assisted core needle biopsy at our institution between January 2001 and December 2011. The center transitioned from film-screen mammography in 2001 to all digital mammography by 2010. Stereotactic vacuum-assisted core needle biopsies were performed using 11-gauge (59/101 [58%]) or 8-gauge (42/101 [42%]) needles. All pathology was interpreted by breast pathologists using standard criteria. Of 101 cases of ADH, 57 (56.4%) were detected using digital and 44 (43.6%) were detected using film-screen mammography. Seven of 57 (12.3%) cases of ADH detected by digital mammography were upgraded to ductal carcinoma in situ (DCIS) (n = 6) or invasive cancer (n = 1). Six of 44 (13.6%) cases of ADH detected by film-screen mammography were upgraded to DCIS (n = 5) or invasive cancer (n = 1) (p = 0.84). There was a trend toward low-grade DCIS in cases detected by digital mammography (3/7 [42.9%]) as compared with film-screen mammography (1/6 [16.7%]) (p = 0.68). A nonsignificant overall higher percentage of upgrades occurred when calcifications were not completely removed (10/52 [19.2%]) as compared with completely removed (3/47 [6.4%]). There was no difference in upgrade rate of stereotactic vacuum-assisted core needle biopsy performed using 11-gauge (7/59 [11.9%]) versus 8-gauge (6/42 [14.3%]) needles. The upgrade rate of ADH diagnosed by stereotactic vacuum-assisted core needle biopsy was not significantly different between digital and film-screen mammography. The current recommendation for excision of ADH diagnosed by stereotactic vacuum-assisted core needle biopsy should be applied to ADH

  14. Is it possible to compare PSA recurrence-free survival after surgery and radiotherapy using revised ASTRO criterion--"nadir + 2"?

    Science.gov (United States)

    Nielsen, Matthew E; Makarov, Danil V; Humphreys, Elizabeth; Mangold, Leslie; Partin, Alan W; Walsh, Patrick C

    2008-08-01

    The new American Society for Therapeutic Radiology and Oncology/Radiation Therapy Oncology Group consensus definition of biochemical failure after radiotherapy for prostate cancer is defined as a prostate-specific antigen level at or greater than the absolute nadir PSA level plus 2 ng/mL. Because this definition inevitably will be used to compare cancer control rates after radiotherapy to those after surgery, this study examined the effect of this comparison. We reviewed the data from 2570 men who had undergone radical prostatectomy from 1985 to 2004. Biochemical failure was defined as any measurable PSA level of 0.2 ng/mL or greater. We evaluated how the nadir+2 definition affected the failure rate when applied to this series. The actuarial 5, 10, and 15-year biochemical recurrence-free survival probability with failure defined as a PSA level of 0.2 ng/mL or more and a PSA level of 2 ng/mL or more was 88.6%, 81.2%, and 78.1% and 94.6%, 89.4%, and 84.3%, respectively (P <0.0001). The median time to biochemical progression was 2.8 years for the greater than 0.2 ng/mL definition and 7.9 years for the 2 ng/mL or more definition. The nadir+2 definition systematically overestimated the biochemical recurrence-free survival, even after stratifying patients into standard prognostic risk groups, especially in men who developed local recurrence. When applied to a mature series of surgically treated patients with localized prostate cancer, the American Society for Therapeutic Radiology and Oncology "nadir+2" definition resulted in a systematic delay in the determination of biochemical failure. Because patients in this series who experienced a detectable PSA level took more than 5 years to progress to a PSA level of 2 ng/mL or greater, the 5-year biochemical control rates with the definition of 0.2 ng/mL or more should be compared with the 10-year biochemical control rates using the nadir+2 definition.

  15. Estimating the harms and benefits of prostate cancer screening as used in common practice versus recommended good practice: A microsimulation screening analysis.

    Science.gov (United States)

    Carlsson, Sigrid V; de Carvalho, Tiago M; Roobol, Monique J; Hugosson, Jonas; Auvinen, Anssi; Kwiatkowski, Maciej; Villers, Arnauld; Zappa, Marco; Nelen, Vera; Páez, Alvaro; Eastham, James A; Lilja, Hans; de Koning, Harry J; Vickers, Andrew J; Heijnsdijk, Eveline A M

    2016-11-15

    Prostate-specific antigen (PSA) screening and concomitant treatment can be implemented in several ways. The authors investigated how the net benefit of PSA screening varies between common practice versus "good practice." Microsimulation screening analysis (MISCAN) was used to evaluate the effect on quality-adjusted life-years (QALYs) if 4 recommendations were followed: limited screening in older men, selective biopsy in men with elevated PSA, active surveillance for low-risk tumors, and treatment preferentially delivered at high-volume centers. Outcomes were compared with a base model in which annual screening started at ages 55 to 69 years and were simulated using data from the European Randomized Study of Screening for Prostate Cancer. In terms of QALYs gained compared with no screening, for 1000 screened men who were followed over their lifetime, recommended good practice led to 73 life-years (LYs) and 74 QALYs gained compared with 73 LYs and 56 QALYs for the base model. In contrast, common practice led to 78 LYs gained but only 19 QALYs gained, for a greater than 75% relative reduction in QALYs gained from unadjusted LYs gained. The poor outcomes for common practice were influenced predominantly by the use of aggressive treatment for men with low-risk disease, and PSA testing in older men also strongly reduced potential QALY gains. Commonly used PSA screening and treatment practices are associated with little net benefit. Following a few straightforward clinical recommendations, particularly greater use of active surveillance for low-risk disease and reducing screening in older men, would lead to an almost 4-fold increase in the net benefit of prostate cancer screening. Cancer 2016;122:3386-3393. © 2016 American Cancer Society. © 2016 American Cancer Society.

  16. Key Characteristics of Combined Accident including TLOFW accident for PSA Modeling

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Bo Gyung; Kang, Hyun Gook [KAIST, Daejeon (Korea, Republic of); Yoon, Ho Joon [Khalifa University of Science, Technology and Research, Abu Dhabi (United Arab Emirates)

    2015-05-15

    The conventional PSA techniques cannot adequately evaluate all events. The conventional PSA models usually focus on single internal events such as DBAs, the external hazards such as fire, seismic. However, the Fukushima accident of Japan in 2011 reveals that very rare event is necessary to be considered in the PSA model to prevent the radioactive release to environment caused by poor treatment based on lack of the information, and to improve the emergency operation procedure. Especially, the results from PSA can be used to decision making for regulators. Moreover, designers can consider the weakness of plant safety based on the quantified results and understand accident sequence based on human actions and system availability. This study is for PSA modeling of combined accidents including total loss of feedwater (TLOFW) accident. The TLOFW accident is a representative accident involving the failure of cooling through secondary side. If the amount of heat transfer is not enough due to the failure of secondary side, the heat will be accumulated to the primary side by continuous core decay heat. Transients with loss of feedwater include total loss of feedwater accident, loss of condenser vacuum accident, and closure of all MSIVs. When residual heat removal by the secondary side is terminated, the safety injection into the RCS with direct primary depressurization would provide alternative heat removal. This operation is called feed and bleed (F and B) operation. Combined accidents including TLOFW accident are very rare event and partially considered in conventional PSA model. Since the necessity of F and B operation is related to plant conditions, the PSA modeling for combined accidents including TLOFW accident is necessary to identify the design and operational vulnerabilities.The PSA is significant to assess the risk of NPPs, and to identify the design and operational vulnerabilities. Even though the combined accident is very rare event, the consequence of combined

  17. BIOCARBURANTS PSA Peugeot Citroën et les biocarburants

    Directory of Open Access Journals (Sweden)

    Maurer Béatrice

    2002-09-01

    Full Text Available Les biocarburants représentent une filière essentielle pour PSA Peugeot Citroën dans le cadre de la protection de l’environnement, un axe stratégique majeur pour le groupe - de la production de ses véhicules au recyclage, de la qualité de l’air à l’effet de serre et au développement d’énergies renouvelables. Depuis plusieurs années, PSA a intégré la filière huiles végétales/biocarburants dans ses activités pour atteindre ses objectifs globaux d’innovation et de croissance. De nombreuses flottes de véhicules circulent en France avec du gazole contenant 30 % de biocarburant issu des oléagineux : une expérience réussie, qui dure depuis plus de dix ans. Le constructeur est favorable à l’utilisation de biocarburants en mélange dans les carburants pétroliers conventionnels, essence et gazole - une voie qui présente plusieurs avantages : * Un bilan CO2 global favorable (par absorption de CO2 lors de la photosynthèse de la plante-source, qui contribue à limiter « l’effet de serre ». * Une source complémentaire de carburant pour réduire les importations de pétrole (et de gazole. * Un soutien au secteur agricole (débouché supplémentaire, dans le cadre de la valorisation des terres en jachère. Issus de la transformation des céréales ou de la betterave à sucre, ou des plantes oléagineuses comme le colza, le tournesol ou le soja, les biocarburants sont par essence des énergies renouvelables. Outre leur bilan exceptionnellement favorable pour lutter contre l’effet de serre, ces carburants offrent de réelles performances environnementales, en particulier par la réduction des émissions de particules (cas des EMHV.

  18. Accuracy of PSA Self-Reports among Low-Income Men with Prostate Cancer after a Public Health Nursing Intervention.

    Science.gov (United States)

    Zavala, Mary Wassel; Yule, Arthur; Kwan, Lorna; Lambrechts, Sylvia; Maliski, Sally L; Litwin, Mark S

    2016-11-01

    To examine accuracy of patient-reported prostate-specific antigen (PSA) levels among indigent, uninsured men in a state-funded prostate cancer treatment program that provides case management, care coordination, and health education. Program evaluation. About 114 men with matched self- and lab-reported PSA levels at program enrollment and another time point within 18 months. Abstraction of self- and lab-reported PSA levels to determine self-report as "accurate" or "inaccurate," and evaluate accuracy change over time, before and after nursing interventions. Chi-square tests compared patients with accurate versus inaccurate PSA values. Nonlinear multivariate analyses explored trends in self-reported accuracy over time. Program enrollees receive prostate cancer education from a Nurse Case Manager (NCM), including significance of PSA levels. Men self-report PSA results to their NCM following lab draws and appointments. The NCM provides ongoing education about PSA levels. Of the sample, 46% (n = 53) accurately reported PSA levels. Accuracy of PSA self-reports improved with increasing time since program enrollment. Compared with men at public facilities, those treated at private facilities showed increasing accuracy in self-reported PSA (p = .038). A targeted nursing intervention may increase specific knowledge of PSA levels. Additionally, the provider/treatment setting significantly impacts a patient's disease education and knowledge. © 2016 Wiley Periodicals, Inc.

  19. PSA-Based Screening Outcomes, Dietary Heterocyclic Amine Exposure, and Prostate Cancer Risk in African Americans

    Science.gov (United States)

    2008-06-01

    vegetables, vitamin D, UV from sunlight, lycopene, and body size (Giovannucci et al., 1997, 1998; Cohen et al., 2000; Chan and Giovannucci, 2001a-b...micronutrients, and risk of prostate cancer. Epidemiol. Rev. 2001a: 23: 82-86. Chan J., and Giovannucci E. Dairy products, calcium, and vitamin D, and risk of...Felton J.S. Genotoxicity of compounds from cooked beef in repair-deficient CHO cells versus salmonella mutagenicity. Mutagen. 1987: 2: 483-487

  20. Evaluating first trimester maternal serum screening combinations for Down syndrome suitable for use with reflexive secondary screening via sequencing of cell free DNA: high detection with low rates of invasive procedures.

    Science.gov (United States)

    Palomaki, Glenn E; Eklund, Elizabeth E; Neveux, Louis M; Lambert Messerlian, Geralyn M

    2015-08-01

    Examine primary Down syndrome screening using combinations of first trimester serum markers, with and without sequencing of cell free DNA as a secondary reflexive test. Samples from 40 Down syndrome cases were matched with five control samples and tested for PAPP-A, free β, AFP, inhibin-A and PlGF. Results were converted to weight-adjusted multiples of the median (MoM) and population parameters computed. Monte Carlo simulation modeled Down syndrome detection and false positive rates for various marker combinations. After reflexive DNA testing, the revised detection and false positive rates were also computed. At a primary false positive rate of 20%, the baseline combination (maternal age, PAPP-A and free β) detected 86.9%. Adding AFP or PlGF increased detection to 89.8% and 89.5%, respectively. Adding AFP and PlGF, AFP and inhibin-A, or all three markers, detected 93.7%, 94.1% and 95.5%, respectively. Modeling reflexive cf DNA testing results in little loss in detection (1%), but false positive rates fall to 0.2%. First trimester reflexive testing does not require nuchal translucency measurements, and has high detection and very low rates of invasive procedures. However, timing of DNA sample collection and the costs of sample collection and DNA testing need to be considered before implementation. © 2015 John Wiley & Sons, Ltd.

  1. prostate cancer screening in ghana - a clinical benefit?

    African Journals Online (AJOL)

    of our study therefore was to provide the basis for the advocacy and promotion of prostate cancer screening in Ghana so as to improve early detection, management and prognosis. To do this, we estimated serum PSA levels of196 men randomly reporting to the Out-Patient Department (OPD) of the Komfo Anokye Teaching ...

  2. 1prostate cancer screening in ghana - a clinical benefit?

    African Journals Online (AJOL)

    Prince Acheampong

    We employed the enzyme immunoassay (EIA) method as our non-invasive screening procedure. ... South Africa and Zimbabwe, it has been observed that the incidence of prostate cancer is increasing between the ages of 40 to ... The enzyme immunoassay (EIA) was adopted for the measurement of PSA. In this method, the ...

  3. Prostate cancer awareness and screening among male public

    African Journals Online (AJOL)

    shanker

    has led to a stage migration with increased detection of early stage, potentially curable disease. Knowledge about PSA screening for PCa among men will lead to increased detection of potentially curable disease. Subjects and methods: Male public servants in Anambra State, Southeast, Nigeria, were invited to complete.

  4. A patient recall program to enhance decisions about prostate cancer screening: A feasibility study

    Directory of Open Access Journals (Sweden)

    Denberg Thomas

    2009-01-01

    Full Text Available Abstract Background Lack of time and competing demands limit the ability of patients and providers to engage in informed decision-making discussions about prostate cancer screening during primary care visits. We evaluated a patient recall invervention to mitigate these challenges. Methods Using mail and telephone outreach we invited men age 50-74 years without a PSA test in the prior 12 months to make appointments with their primary care providers in order to discuss the pros and cons of PSA-based prostate cancer screening. We assessed patient responsiveness to the program, provider documentation of screening discussions, orders for PSA laboratories, and provider attitudes. Results Out of 80 eligible patients, 37 (46% scheduled and 28 (35% completed a recall appointment. A large majority (91% of patients eligible for PSA screening received an order for this test. Providers documented PSA discussions more often for these patients than for a recent sample of their other patients who received traditional care (47.8% vs. 12.5%, p = 0.009. Twelve of 14 participating providers felt the program improved their ability to impart information about the risks and benefits of screening, but were uncertain whether it influenced their patients' preexisting preferences for screening. Some expressed doubts about the advisability of PSA-specific appointments. Conclusion To a limited extent, this pilot recall intervention enhanced opportunities for discussions of prostate cancer screening between patients and their primary care providers. As currently configured, however, this program was not found to be feasible for this purpose. A future version should promote screening discussions in the context of a broader range of health maintenance concerns and include more detailed, low-literacy information to educate patients in advance of clinic visits.

  5. Cervical cancer screening cotesting with cytology and MRNA HPV E6/E7 yields high rates of CIN2+ lesions in young women.

    Science.gov (United States)

    Granados, Rosario; Tellez-Safina, Hilda; Solis, Isabel; Mateos, Francisco; Rodriguez-Barbero, Jose Maria; Aramburu, Jose Antonio; Huertas, Miguel Angel; Bajo, Paloma; Camarmo, Encarnacion; Corrales, Teresa; Medina, Pedro; Calvo, Beatriz; Martin, Esther; Anta, Laura; Zamora, Manuel; Alcaide, Teresa

    2017-12-01

    European guidelines recommend primary HPV testing for cervical cancer screening. However, the starting age remains to be defined, with an undecided window between 30 and 35 years. This pilot study compares the effectiveness of primary HPV testing to that of cytology for the detection of high-grade (CIN2+) lesions stratified by age. Cotesting with LBC cytology and APTIMA® HPV (AHPV) was performed in 5053 women aged 25-65 in an opportunistic screening program in Madrid. AHPV-positive cases were referred to colposcopy and genotyped for HPV16 and 18/45 (AHPV-GT). Results were analyzed stratified in four age groups. 454 cases (9.0%) were AHPV-positive. Women under 35 had a 30.2% CIN2+ rate, compared to 21.9% and 20.4% for women aged 35-44 or 45-54. There was a significant increase (P < .05) in the rate of CIN2+ in AHPV-GT-positive women when compared to that for other HPV types (AHPV-other), being 43.3% versus 15.7%. AHPV-GT-positive women under 35 had significantly higher rates of CIN2+ lesions than any other age-group. The sensitivity of cytology for cervical CIN2+ in APHV-positive women was 60.6%. All 4 carcinomas, including one AHPV-negative endometrial adenocarcinoma, had abnormal cytology. All cervical CIN2+ lesions biopsied were AHPV-positive. Aptima HPV shows a significantly higher sensitivity for cervical CIN2+ lesions than cytology alone. Unexpectedly, AHPV-positive women under 35 had the highest incidence of CIN2+ lesions, particularly when they are HPV16/18/45-positive. Reconsidering HPV primary screening before the recommended age of 35 is warranted. © 2017 Wiley Periodicals, Inc.

  6. Potentiometric stripping analysis (PSA) for monitoring of antimony in samples of vegetation from a mining area

    Energy Technology Data Exchange (ETDEWEB)

    Toro Gordillo, M.C.; Pinilla Gil, E. [Dept. de Quimica Analitica y Electroquimica, Universidad de Extremadura, Badajoz (Spain); Rodriguez Gonzalez, M.A.; Murciego Murciego, A. [Area de Cristalografia y Mineralogia, Universidad de Extremadura, Badajoz (Spain); Ostapczuk, P. [Forschungszentrum Juelich GmbH (Germany)

    2001-06-01

    A potentiometric stripping analysis (PSA) method has been developed and checked for the fast and reliable determination of antimony in vegetation samples of Cistus ladanifer from a mining area in Badajoz, Southwest Spain. The method, modified from previous PSA methods for Sb in environmental samples, is based on dry ashing of the homogenized leaves, dissolution in hydrochloric acid, and PSA analysis on a mercury film plated on to a glassy carbon disk electrode. The influence of experimental variables such as the deposition potential, the deposition time, the signal stability and the calibration parameters, has been investigated. The method has been compared with an independent technique (instrumental neutron activation analysis) by analysis of standards and reference materials and comparison of the results. As a result of automation of the PSA equipment, the proposed method enables unattended analysis of 20 digested samples in a total time of 2 h, thus providing a useful tool for Sb monitoring of a large number of samples. (orig.)

  7. Potentiometric stripping analysis (PSA) for monitoring of antimony in samples of vegetation from a mining area.

    Science.gov (United States)

    Toro Gordillo, M C; Pinilla Gil, E; Rodríguez González, M A; Murciego Murciego, A; Ostapczuk, P

    2001-06-01

    A potentiometric stripping analysis (PSA) method has been developed and checked for the fast and reliable determination of antimony in vegetation samples of Cistus ladanifer from a mining area in Badajoz, Southwest Spain. The method, modified from previous PSA methods for Sb in environmental samples, is based on dry ashing of the homogenized leaves, dissolution in hydrochloric acid, and PSA analysis on a mercury film plated on to a glassy carbon disk electrode. The influence of experimental variables such as the deposition potential, the deposition time, the signal stability and the calibration parameters, has been investigated. The method has been compared with an independent technique (instrumental neutron activation analysis) by analysis of standards and reference materials and comparison of the results. As a result of automation of the PSA equipment, the proposed method enables unattended analysis of 20 digested samples in a total time of 2 h, thus providing a useful tool for Sb monitoring of a large number of samples.

  8. A Diet, Physical Activity, and Meditation Intervention in Men With Rising Prostate-Specific Antigen (PSA)

    National Research Council Canada - National Science Library

    Hebert, James R

    2006-01-01

    ... physical activity and mindfulness-based stress reduction. This randomized trial will enroll 60 men with rising PSA levels along with a partner of their choice, half of whom will be randomized to the intervention and half to usual care...

  9. A Diet, Physical Activity, and Mediation Intervention in Men With Rising Prostate-Specific Antigen (PSA)

    National Research Council Canada - National Science Library

    Hebert, James

    2004-01-01

    ... physical activity and mindfulness-based stress reduction. This randomized trial will enroll 60 men with rising PSA levels along with a partner of their choice, half of whom will be randomized to the intervention and half to usual care...

  10. A Diet, Physical Activity, and Meditation Intervention in Men With Rising Prostate-Specific Antigen (PSA)

    National Research Council Canada - National Science Library

    Hebert, James R

    2007-01-01

    ... physical activity and mindfulness-based stress reduction. This randomized trial will enroll 60 men with rising PSA levels along with a partner of their choice, half of whom will be randomized to the intervention and half to usual care...

  11. Radiographic progression with nonrising PSA in metastatic castration-resistant prostate cancer

    DEFF Research Database (Denmark)

    Bryce, A H; Alumkal, J J; Armstrong, A

    2017-01-01

    BACKGROUND: Advanced prostate cancer is a phenotypically diverse disease that evolves through multiple clinical courses. PSA level is the most widely used parameter for disease monitoring, but it has well-recognized limitations. Unlike in clinical trials, in practice, clinicians may rely on PSA...... monitoring alone to determine disease status on therapy. This approach has not been adequately tested. METHODS: Chemotherapy-naive asymptomatic or mildly symptomatic men (n=872) with metastatic castration-resistant prostate cancer (mCRPC) who were treated with the androgen receptor inhibitor enzalutamide...... treated with enzalutamide. As restaging in advanced prostate cancer patients is often guided by increases in PSA levels, our results demonstrate that disease progression on enzalutamide can occur without rising PSA levels. Therefore, a disease monitoring strategy that includes imaging not entirely reliant...

  12. A population study of fasting time and serum prostate-specific antigen (PSA) level

    National Research Council Canada - National Science Library

    Lau, Cheryl K; Guo, Maggie; Viczko, Jeannine A; Naugler, Christopher T

    2014-01-01

    .... Recently, it has been shown that fasting extremes can affect concentrations of serum chemistry analytes, thus raising the question of whether or not fasting has an effect on the highly sensitive PSA biomarker...

  13. Safety analyses: the importance of PSA and ZEDB. ZEDB: tool determining plant-specific reliability data; Sicherheitsanalysen, Bedeutung von PSA und ZEDB. ZEDB: Instrument zur Ermittlung anlagenspezifischer Zuverlaessigkeitsdaten

    Energy Technology Data Exchange (ETDEWEB)

    Brahmstaedt, Kai-Uwe [E.ON Kernkraft GmbH, Kernkraftwerk Brokdorf (Germany); Schubert, Bernd [Vattenfall Europe Nuclear Energy GmBH, Stoerfall- und Zuverlaessigkeitsanalysen, Anlagentechnik, Hamburg (Germany); Seidel, Andre [VGB Power Tech e.V., Essen (Germany)

    2009-06-15

    Safety inspections of nuclear power plants under the Atomic Energy Act are regulated, inter alia, in the Probabilistic Safety Analysis (PSA) guideline. These analyses are performed in addition to the safety assessments based, on deterministic principles. In this way, the influence of components, systems, and structures, as well as actions by personnel, on plant behavior in terms of technical safety can be described in a holistic approach and the safety level thus can be assessed quantitatively. Conducting a PSA requires plant-specific reliability data which are determined in the plant in question, but are also collected and stored centrally in the central reliability and event database (ZEDB). (orig.)

  14. The association of general practitioners’ risk attitudes, level of empathy and burnout status with PSA testing

    DEFF Research Database (Denmark)

    Pedersen, Anette Fischer; Carlsen, Anders Helles; Vedsted, Peter

    2015-01-01

    Når alment praktiserende læger sammenlignes, finder man ofte stor variation i raten af PSA-tests foretaget på mandlige patienter. Dette studie viser, at lægens risikovillighed influerer på raten af PSA-tests. Således har patienter, som er registreret hos en læge, som har mange bekymringer for fej...

  15. utility of prostate specific antigen (psa) in the indigenous african man

    African Journals Online (AJOL)

    categories of ≤4ng/ml and >4ng/ml in ratios of 3.3:1 and 1.5:1 respectively. It, however, had PSA levels between 2 and 15 ng/ml. The odd ratio for BPH to be in the normal range was 2.0 while cancer of the prostate had a 1.7 odd ratio for elevated PSA. Seven patients clinically diagnosed as BPH had histological findings of ...

  16. Effect of gynecological screening on rates of conception and gestation total of Nellore cows submitted to three protocols for fixed-time artificial insemination (TAI

    Directory of Open Access Journals (Sweden)

    Gustavo Fernandes Grillo

    2015-10-01

    Full Text Available ABSTRACT. Grillo G.F., Guimarães A.L.L., Soares J.R., Mello M.R.B., Alonso L.S., Abidú-Figueiredo M. & Palhano H.B. [Effect of gynecological screening on rates of conception and gestation total of Nellore cows submitted to three protocols for fixed-time artificial insemination (TAI.] Efeito da triagem ginecológica sobre as taxas de concepção e gestação total de vacas Nelore submetidas a três protocolos de inseminação artificial em tempo fixo (IATF. Revista Brasileira de Medicina Veterinária, 37(3:250-254, 2015. Área de Anatomia, Departamento de Biologia Animal, Instituto de Biologia, Universidade Federal Rural do Rio de Janeiro, Campus Seropédica, BR 465 km 7, Seropédica, RJ 23890-000, Brasil. Email: helcimarpalhano@gmail.com The aim of this study was to assess the rates of total conception and gestation of Nellore cows total, commercial herd in the region of the coastal plains of the state of RJ, subjected to three hormonal protocols for synchronization of ovulation with screening of females for inclusion in the TAI program. Two hundred and six lactating females with multiple calvings history were used (60 to 100 days after parturition, divided into four groups: I - Ovsynch, n = 55, II - Ovsynch + progesterone, n = 55, III - EB. + P4 + eCG, n = 48, IV - EB. + P4 + eCG, n = 48. All females were exposed to bulls of Simmental breed, from 24 hours to pass after TAI. The conception rates and pregnancy rates were 45.5% overall (25:55 and 81.8% (45:55 for group I, 61.8% (34:55 and 87.3% (48 : 55 for group II, 62.5% (30:48 and 87.5% (42:48 for group III, 60.4% (29:48 and 83.3% (40:48 for group IV, respectively. The results, after analysis by the chi- -square showed no significant difference (p> 0.05 among protocols, as compared to the conception and pregnancy rates after transfer with total bulls. Thus, the use of gynecological screening for insertion of cows in the TAI program of the respective property, allows adaptation of the

  17. The Hidden Burden of Outpatient Repeat PSA Testing in a Prospective Cohort

    LENUS (Irish Health Repository)

    Browne, E

    2017-05-01

    PSA testing is widespread throughout Europe for diagnostic purposes and follow up. We performed a prospective outpatient cohort study of 250 men (2013-2015) in two hospital sites. Included were those men being followed up by urology with PSA blood testing. First appointments and those men in whom non-PSA tests were ordered by urology were excluded. The median age was 67.2yrs (46-88). Eighty-one point two percent of samples had a combination of 21 different serology tests at an added cost of >€18,000. Abnormal serology resulted in 53 referrals. Twenty-six-six percentof correspondence referenced abnormal serology other than PSA. Follow up of non-PSA test results poses a challenge in an outpatient setting with failure to appropriately follow-up on abnormal results, increased costs, and medico-legal implications. There is currently no Irish legislature in place to safeguard hospital physicians. This study quantifies the levels of expenditure, resources and risk associated with ambulant PSA testing.

  18. Can the Free/Total PSA Ratio Predict the Gleason Score Before Prostate Biopsy?

    Science.gov (United States)

    Ceylan, Cavit; Gazel, Eymen; Keleş, İbrahim; Doluoğlu, Ömer; Yığman, Metin

    2016-02-01

    To determine whether there is a correlation between high Gleason score and free/total (f/t) prostate specific antigen (PSA) in patients newly diagnosed with prostate carcinoma. The study included 272 prostate biopsy patients whose total PSA value ranged from 4-10 ng/ml. The patients were divided into 2 groups according to the f/t PSA ratio: Group 1 ≤ 15% and Group 2 > 15%. Furthermore, the groups were also compared to each other in terms of mild (≤ 6), moderate (= 7), and high (≥ 8) Gleason score. Group 1 consisted of 135 (49.6%) patients and Group 2 consisted of 137 (50.4%) patients. While 27 (20%) patients had a high Gleason score in Group 1, only 10 (7.3%) patients had a high Gleason score in Group 2 (p = 0.008). Using Spearman's correlation test, we found that the f/t PSA ratios were observed to decrease significantly in all patients with increased Gleason scores (p = 0.002, r = -0.185). According to our study, there is a relationship between higher Gleason score and decreased f/t PSA ratio. Therefore, f/t PSA can be an indicator for predicting the Gleason score.

  19. A cluster-randomised, parallel group, controlled intervention study of genetic prostate cancer risk assessment and use of PSA tests in general practice--the ProCaRis study

    DEFF Research Database (Denmark)

    Kirkegaard, Pia; Vedsted, Peter; Edwards, Adrian

    2013-01-01

    PSA-testen er det bedste og mest anvendte værktøj til at opspore prostatacancer. Testen er dog behæftet med fejlkilder, som kan føre til overflødig udredning, diagnosticering og behandling. Ved udredning tages biopsier med risiko for behandlingskrævende infektion. Behandlingen for prostatacancer...... fører ofte til vandladningsproblemer og impotens, og den har ikke vist sig specielt effektiv i behandling af den aggressive prostatacancer. Risikoen for overdiagnostik og overbehandling betyder, at PSA-testen ikke anvendes til generel screening for prostatakræft. Alligevel får mange patienter taget en...... PSA-test - ofte flere gange - måske fordi de ser sig selv som værende i særlig risiko. I ProCaRis-studiet får udvalgte praksis i Region Midtjylland mulighed for at tilbyde en genetisk risikovurdering for prostatakræft til patienter, som skal have en PSA-test. Den genetiske risikovurdering kan afgøre...

  20. High false-positive rate of human immunodeficiency virus rapid serum screening in a predominantly hispanic prenatal population.

    Science.gov (United States)

    Zacharias, Nikolaos M; Athanassaki, Ioanna D; Sangi-Haghpeykar, Haleh; Gardner, Michael O

    2004-12-01

    To identify the characteristics of the gravidas delivering at our birthing center that place them at risk for false-positive human immunodeficiency virus (HIV) enzyme-linked immunosorbent assay (ELISA). The medical records of all rapid HIV-ELISA-positive gravidas that delivered at our hospital between January 2000 and October 2001 were retrieved, and information was gathered regarding maternal demographics. The results of the Western blot tests were also retrieved and correlated to the ELISA results, across varying maternal characteristics. chi(2), Student's t-test and multivariate analysis were performed, as appropriate, using the SAS software; statistical significance was denoted by ppositive rapid HIV-ELISA out of 9,781 deliveries. Of those, 26 were confirmed as HIV infected by Western blot (overall HIV prevalence: 0.27%, ELISA-positive predictive value: 37.7%). The subgroup prevalence of HIV and positive predictive value of ELISA were 1.53 and 75% among Caucasians; 2.43 and 82.6% among African-Americans; and 0.05 and 9.8% among Hispanics, respectively (p or =5 lifetime) sexual partners was elicited in the majority of HIV-infected patients. The positive predictive value of rapid HIV-ELISA during pregnancy varies widely, depending on maternal race/ethnicity and sexual behavior. The routine disclosure of rapid intrapartum HIV serum screening results prior to Western blot confirmation should be avoided in very low-risk populations.

  1. Development of computing code system for level 3 PSA

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Jong Tae; Yu, Dong Han; Kim, Seung Hwan

    1997-07-01

    Among the various research areas of the level 3 PSA, the effect of terrain on the transport of radioactive material was investigated through wind tunnel experiment. These results will give a physical insight in the development of a new dispersion model. Because there are some discrepancies between the results from Gaussian plume model and those from field test, the effect of terrain on the atmospheric dispersion was investigated by using CTDMPLUS code. Through this study we find that the model which can treat terrain effect is essential in the atmospheric dispersion of radioactive materials and the CTDMPLUS model can be used as a useful tool. And it is suggested that modification of a model and experimental study should be made through the continuous effort. The health effect assessment near the Yonggwang site by using IPE (Individual plant examination) results and its site data was performed. The health effect assessment is an important part of consequence analysis of a nuclear power plant site. The MACCS was used in the assessment. Based on the calculation of CCDF for each risk measure, it is shown that CCDF has a slow slope and thus wide probability distribution in cases of early fatality, early injury, total early fatality risk, and total weighted early fatality risk. And in cases of cancer fatality and population dose within 48km and 80km, the CCDF curve have a steep slope and thus narrow probability distribution. The establishment of methodologies for necessary models for consequence analysis resulting form a server accident in the nuclear power plant was made and a program for consequence analysis was developed. The models include atmospheric transport and diffusion, calculation of exposure doses for various pathways, and assessment of health effects and associated risks. Finally, the economic impact resulting form an accident in a nuclear power plant was investigated. In this study, estimation models for each cost terms that considered in economic

  2. Guidance to risk-informed evaluation of technical specifications using PSA

    Energy Technology Data Exchange (ETDEWEB)

    Baeckstroem, O.; Haeggstroem, A. (Scandpower AB, Stockholm (Sweden)); Maennistoe, I. (VTT, Helsingfors (Finland))

    2010-04-15

    This report presents guidance for evaluation of Technical Specification conditions with PSA. It covers quality in PSA, how to verify that the PSA model is sufficiently robust and sufficiently complete and general requirements on methods. Acceptance criteria for evaluation of changes in the TS conditions are presented. As the probabilistic safety assessment (PSA) has developed over the years, it has demonstrated to constitute a useful tool for evaluating many aspects of the TS from a risk point of view. and in that way making the PSAs as well as the decision tools better. This also means that it will be possible to take credit for safety system overcapacity as well as inherent safety features and strength of non-safety classed systems. However, PSA is only one of the tools that shall be used in an evaluation process of TS changes (strengthening/relaxation). PSA is an excellent tool to be used to verify the importance, and thereby possibly relaxation, of TS requirements. But, since PSA is only one tool in the evaluation, it is not sufficient in itself for defining which equipment that shall or shall not have TS requirements. The purpose of this guidance document is to provide general requirements, requirements on methods and acceptance criteria on risk-informed evaluation of TS changes based on PSA. The purpose is not to provide a single solution. As part of the review of the TS conditions this guidance specify requirements on: - Quality verification of the PSA model; - Verification that the PSA model is sufficiently robust with regard to SSCs for which requirements both are and are not defined by the TS; - Verification that the SSCs, for which TS demands are to be evaluated, are modelled in a sufficient manner; - Methods for performing the evaluation; - Which evaluation criteria that shall be used (and how that is verified to be correct); - Acceptance criteria: This guidance also briefly discusses the documentation of the analysis of the TS changes. This guidance

  3. Automated installation for gas separation and purification using the Pressure Swing Adsorption (PSA) process; Instalacao automatizada para separacao e purificacao de gases por PSA

    Energy Technology Data Exchange (ETDEWEB)

    Neves, Celia F. Cordeiro; Schvartzman, Monica M.A.M. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN), Belo Horizonte, MG (Brazil); Jordao, Elizabete [Universidade Estadual de Campinas, SP (Brazil). Dept. de Engenharia de Sistemas Quimicos e Informatica

    1999-11-01

    This paper describes the first laboratorial PSA (Pressure Swing Adsorption) unit designed and built in Brazil for gas separation by adsorption process. It consists of a stainless steel column, which was filled with zeolite 5A molecular sieve. Six solenoid valves located at the feed., product, countercurrent and high-pressure air lines were used to regulate the flow directions of different streams. Pressure and flowrate transducers and thermocouples were used to record respectively the pressure, flowrate of both feed and product stream and temperature history of the process. These instruments and the solenoid valves were joined to a programmable logic controller. By the use of a computer the unit can be automatically operated to simulate all steps in the PSA cycle and data can be easily acquired and recorded. The unit will be used to study basic parameters of PSA processes and to separate several gas mixtures. As a first goal the unit will be operated to produce oxygen-enriched air using synthetic zeolites. This PSA laboratory unit is an important step in CDTN`s objective of consolidating a research group in gas separation by adsorption processes. (author) 7 refs., 8 figs., 2 tabs.

  4. HCC screening; HCC-Screening

    Energy Technology Data Exchange (ETDEWEB)

    Albrecht, T. [Charite-Unversitaetsmedizin,Freie Universitaet und Humboldt-Universitaet zu Berlin, Klinik und Hochschulambulanz fuer Radiologie und Nuklearmedizin,Campus Benjamin Franklin, Berlin (Germany)

    2008-01-15

    Hepatocellular carcinoma (HCC) is one of the most frequently diagnosed tumour diseases throughout the world. In the vast majority of cases those affected are high-risk patients with chronic viral hepatitis and/or liver cirrhosis, which means there is a clearly identifiable target group for HCC screening. With resection, transplantation, and interventional procedures for local ablation, following early diagnosis curative treatment options are available with which 5-year survival rates of over 60% can be reached. Such early diagnosis is a reality only in a minority of patients, however, and in the majority of cases the disease is already in an advanced stage at diagnosis. One of the objects of HCC screening is diagnosis in an early stage when curative treatment is still possible. Precisely this is achieved by screening, so that the proportion of patients treated with curative intent is decisively higher. There is not yet any clear evidence as to whether this leads to a lowering of the mortality of HCC. As lower mortality is the decisive indicator of success for a screening programme the benefit of HCC screening has so far been neither documented nor refuted. Nonetheless, in large regions of the world it is the practice for high-risk patients to undergo HCC screening in the form of twice-yearly ultrasound examination and determination of AFP. (orig.) [German] Das hepatozellulaere Karzinom (HCC) ist eine der weltweit haeufigsten Tumorerkrankungen. Es tritt in der grossen Mehrzahl der Faelle bei Hochrisikopatienten mit chronischer Virushepatitis bzw. Leberzirrhose auf, woraus sich eine klar identifizierbare Zielgruppe fuer das HCC-Screening ergibt. Mit der Resektion, der Transplantation und interventionellen lokal ablativen Verfahren stehen bei rechtzeitiger Diagnosestellung kurative Therapieoptionen zur Verfuegung, die 5-Jahres-Ueberlebensraten von >60% erreichen. Diese rechtzeitige Diagnosestellung erfolgt jedoch nur bei einer Minderzahl der Patienten, waehrend die

  5. Combining Taipan snake venom time/Ecarin time screening with the mixing studies of conventional assays increases detection rates of lupus anticoagulants in orally anticoagulated patients

    Directory of Open Access Journals (Sweden)

    Moore Gary W

    2007-09-01

    Full Text Available Abstract Background Oral anticoagulation compromises conventional lupus anticoagulant (LA screening assays. Mixing studies can counteract the oral anticoagulant effect but the dilution reduces sensitivity and can generate false negative results. A firm diagnosis can be made from mixing studies when an elevated screen ratio is accompanied by a confirm ratio that generates significant correction to demonstrate phospholipid dependence, but also returns into the reference range, indicating complete normalisation of the oral anticoagulant effect. Taipan snake venom time (TSVT with Ecarin time (ET as a confirmatory test comprises an oral anticoagulant insensitive LA detection system and this study investigates the potential impact on detection rates when coupled with mixing studies on standard assays. Methods Eighty patients known to have LA who were receiving oral anticoagulation were tested with TSVT/ET and 1:1 mixing studies with normal plasma by dilute Russell's viper venom time (DRVVT and dilute activated partial thromboplastin time (DAPTT to assess detection rates by single and multiple assays. Results Thirty three of the 80 samples from known LA positive patients were positive in all three assays and 15 were positive in combinations of DRVVT, DAPTT or TSVT/ET. The remainder were positive in only one assay; 12 by DRVVT, 4 by DAPTT and 16 by TSVT/ET. Although all DRVVT and DAPTT positive mixing studies generated significant correction of the screen ratio by the confirm ratio, not all confirm ratios corrected back into the reference range. This was the case for 87.5% of the DRVVT results, 44.7% of the DAPTT results and 13.3% of the TSVT/ET positive mixing tests. Conclusion Addition of TSVT/ET screening for LA in orally anticoagulated patients could increase diagnostic efficacy either by detecting antibodies diluted in the mixing tests of conventional assays or those that do not react in DRVVT or DAPTT. Additionally, TSVT/ET can affirm the presence

  6. The readiness of German GPs to recommend and conduct cancer screening is associated with patient-physician gender concordance. Results of a survey.

    Science.gov (United States)

    Engler, Jennifer; Dahlhaus, Anne; Güthlin, Corina

    2017-12-01

    Cancer screening participation rates in Germany differ depending on patients' gender. International studies have found that patient-physician gender concordance fosters recommendation and conducting of cancer screening, and especially cancer screening for women. We aimed to ascertain whether gender concordance influences general practitioners' (GPs') rating of the usefulness of cancer screening, as well as their recommendations and readiness to conduct cancer screening in general practice in Germany. For an exploratory cross-sectional survey, 500 randomly selected GPs from all over Germany were asked to fill in a questionnaire on cancer screening in general practice between March and June 2015. We asked them to rate the usefulness of each cancer screening examination, how frequently they recommended and conducted them and whether they viewed GPs or specialists as responsible for carrying them out. We used multiple logistic regression to analyse gender effect size by calculating odds ratios. Our study sample consisted of 139 GPs of which 65% were male. Male and female GPs did not differ significantly in their rating of the general usefulness of any of the specified cancer screening examinations. Male GPs were 2.9 to 6.8 times as likely to consider GPs responsible for recommending and conducting PSA testing and digital rectal examinations and were 3.7 to 7.9 times as likely to recommend and conduct these examinations on a regular basis. Patient-physician gender concordance made it more likely that male-specific cancer screenings would be recommended and conducted, but not female-specific screenings. [Box: see text].

  7. Serum PSA and cure perspective for prostate cancer in males with nonpalpable tumor

    Directory of Open Access Journals (Sweden)

    Marcos F. Dall'Oglio

    2005-10-01

    Full Text Available INTRODUCTION: Many studies have shown the association between PSA levels and the subsequent detection of prostate cancer. In the present trial, we have studied the relationship between preoperative PSA levels and clinical outcome following radical prostatectomy in men with clinical stage T1c. MATERIALS AND METHODS: 257 individuals with clinical stage T1c undergoing retropubic radical prostatectomy were selected in the period from 1991 to 2000. Following surgery, biochemical recurrence-free survival curves were constructed according to PSA levels between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL. RESULTS: Of the total of 257 selected patients, 206 (80% had Gleason scores from 2 to 6 and 51 (20%, presented Gleason scores 7 and 8, as defined by the pathological report from prostate biopsy. There was no biochemical recurrence of disease when the PSA was lower than 4, regardless of Gleason score. Biochemical recurrence-free survival according to PSA between 0-4; 4.1-10; 10.1-20 and > 20 was 100%, 87.6%, 79% and 68.8% for Gleason scores 2-6 and 100%; 79.4%; 40% and 100% for Gleason scores 7-8 respectively. When all individuals were grouped, regardless of their Gleason scores, the probability of biochemical recurrence-free survival was 100%, 65.1%, 53.4% and 72.2% according to PSA between 0-4; 4.1-10; 10.1-20 and > 20 ng/mL respectively. CONCLUSION: Non-palpable prostate cancer presents higher chances of cure when the PSA is inferior to 4 ng/mL.

  8. Correlation Between MRS and Serum PSA in the Diagnosis of Local Recurrence After Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    M Ghafuri

    2012-08-01

    Full Text Available Background: Multifocality, multicentricity and extension beyond the prostate capsule are all characteristics of prostatic adenocarcinoma that may escape diagnosis by conventional CT scanning or MRI. This study was designed to assess the diagnostic value of magnetic resonance spectroscopy (MRS in prostatic carcinoma and its compatibility with prostatic specific antigen (PSA as the conventional method.Methods: In this cross-sectional study, we recruited 139 patients with previous radical prostatectomy referring to Radiology department of Hazrate-e-Rasul Hospital during the first half of 2011 for the evaluation of local recurrence. Traditionally, local recurrence is defined as serum PSA concentration >0.2 ng/dl. We used 1.5-tesla Siemens Avanto MRI unit with endorectal coil and measured creatine, choline and citrate levels before calculating choline-creatine/citrate ratio. Correlation between MRS findings with PSA concentration was evaluated in regards to the multiple levels of the previously mentioned ratio.Results: Local recurrence was found in 107 (77% patients based on PSA levels. The mean values for serum PSA levels and creatine-choline/citrate ratio were significantly different in patients with and without local recurrence. Creatine-choline/citrate ratios greater than 50, 100 and 150 (as different cut-off points of recurrence were respectively seen in 104, 102 and 97 patients and agreement ratio between MRS and PSA in these levels were 94.1%, 94.4% and 85.1%, respectively. Correlation coefficient between these two methods was 0.481.Conclusion: MRS is a valuable tool for evaluating recurrence inpatients with prostate cancer treated by radical prostatectomy and it is in good agreement with serum PSA levels.

  9. Screening the dystrophin gene suggests a high rate of polymorphism in general but no exonic deletions in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Lindor, N.M.; Sobell, J.L.; Thibodeau, S.N. [Mayo Clinic/Foundation, Rochester, MN (United States)] [and others

    1994-03-15

    The dystrophin gene, located at chromosome Xp21, was evaluated as a candidate gene in chronic schizophrenia in response to the report of a large family in which schizophrenia cosegregated with Becker muscular dystrophy. Genomic DNA from 94 men with chronic schizophrenia was evaluated by Southern blot analysis using cDNA probes that span exons 1-59. No exonic deletions were identified. An unexpectedly high rate of polymorphism was calculated in this study and two novel polymorphisms were found, demonstrating the usefulness of the candidate gene approach even when results of the original study are negative. 41 refs., 1 fig., 4 tabs.

  10. An Objective Screening Method for Major Depressive Disorder Using Logistic Regression Analysis of Heart Rate Variability Data Obtained in a Mental Task Paradigm

    Directory of Open Access Journals (Sweden)

    Guanghao Sun

    2016-11-01

    Full Text Available Background and Objectives: Heart rate variability (HRV has been intensively studied as a promising biological marker of major depressive disorder (MDD. Our previous study confirmed that autonomic activity and reactivity in depression revealed by HRV during rest and mental task (MT conditions can be used as diagnostic measures and in clinical evaluation. In this study, logistic regression analysis (LRA was utilized for the classification and prediction of MDD based on HRV data obtained in an MT paradigm.Methods: Power spectral analysis of HRV on R-R intervals before, during, and after an MT (random number generation was performed in 44 drug-naïve patients with MDD and 47 healthy control subjects at Department of Psychiatry in Shizuoka Saiseikai General Hospital. Logit scores of LRA determined by HRV indices and heart rates discriminated patients with MDD from healthy subjects. The high frequency (HF component of HRV and the ratio of the low frequency (LF component to the HF component (LF/HF correspond to parasympathetic and sympathovagal balance, respectively.Results: The LRA achieved a sensitivity and specificity of 80.0% and 79.0%, respectively, at an optimum cutoff logit score (0.28. Misclassifications occurred only when the logit score was close to the cutoff score. Logit scores also correlated significantly with subjective self-rating depression scale scores (p < 0.05.Conclusion: HRV indices recorded during a mental task may be an objective tool for screening patients with MDD in psychiatric practice. The proposed method appears promising for not only objective and rapid MDD screening, but also evaluation of its severity.

  11. Have You Been Tested for Colorectal Cancer? PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-11-05

    This 60 second public service announcement is based on the November 2013 CDC Vital Signs report. Colorectal cancer screening saves lives, but only if you get tested. If you’re between 50 and 75, talk with your doctor about which test is best for you. If you have inflammatory bowel disease or a family history of colorectal cancer or polyps, ask your doctor if you should start screening before age 50.  Created: 11/5/2013 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/5/2013.

  12. Presence of a [3Fe-4S] cluster in a PsaC variant as a functional component of the photosystem I electron transfer chain in Synechococcus sp. PCC 7002.

    Science.gov (United States)

    Pérez, Adam A; Ferlez, Bryan H; Applegate, Amanda M; Walters, Karim; He, Zhihui; Shen, Gaozhong; Golbeck, John H; Bryant, Donald A

    2017-09-15

    A site-directed C14G mutation was introduced into the stromal PsaC subunit of Synechococcus sp. strain PCC 7002 in vivo in order to introduce an exchangeable coordination site into the terminal FB [4Fe-4S] cluster of Photosystem I (PSI). Using an engineered PSI-less strain (psaAB deletion), psaC was deleted and replaced with recombinant versions controlled by a strong promoter, and the psaAB deletion was complemented. Modified PSI accumulated at lower levels in this strain and supported slower photoautotrophic growth than wild type. As-isolated PSI complexes containing PsaCC14G showed resonances with g values of 2.038 and 2.007 characteristic of a [3Fe-4S]1+ cluster. When the PSI complexes were illuminated at 15 K, these resonances partially disappeared and two new sets of resonances appeared. The majority set had g values of 2.05, 1.95, and 1.85, characteristic of FA-, and the minority set had g values of 2.11, 1.90, and 1.88 from FB' in the modified site. The S = 1/2 spin state of the latter implied the presence of a thiolate as the terminal ligand. The [3Fe-4S] clusters could be partially reconstituted with iron, producing a larger population of [4Fe-4S] clusters. Rates of flavodoxin reduction were identical in PSI complexes isolated from wild type and the PsaCC14G variant strain; this implied equivalent capacity for forward electron transfer in PSI complexes that contained [3Fe-4S] and [4Fe-4S] clusters. The development of this cyanobacterial strain is a first step toward translation of in vitro PSI-based biosolar molecular wire systems in vivo and provides new insights into the formation of Fe/S clusters.

  13. Percentage of free prostate-specific antigen (PSA) is a useful method in deciding to perform prostate biopsy with higher core numbers in patients with low PSA cut-off values.

    Science.gov (United States)

    Yilmaz, Hasan; Ciftci, Seyfettin; Yavuz, Ufuk; Ustuner, Murat; Saribacak, Ali; Dillioglugil, Ozdal

    2015-06-01

    The aim of this study was to evaluate the predictive role of percentage of free prostate-specific antigen (%fPSA) cut-points in prostate cancer (PCa) detection in patients with total PSA (tPSA) levels between 2.5 ng/mL and 10.0 ng/mL. In total, 1321 consecutive initial transrectal ultrasound (TRUS)-guided 12-core biopsies performed between 2005 and 2011 were evaluated retrospectively. Benign pathologies, high-grade prostatic intraepithelial neoplasia, and atypical small acinary proliferations were categorized as noncancerous (benign), and prostate adenocarcinomas were categorized as cancerous (malignant). The patients were categorized according to: Catalona's published %fPSA categories ( 25%); digital rectal examination (DRE) results [benign (negative) or suspicious of malignancy (positive)]. There was a significant relationship between the %fPSA cut-points and detection of PCa in DRE-negative patients. The presence of a 10% cut-point increased the probability of PCa threefold. The %fPSA was significantly more related to PCa than the tPSA value in receiver operating characteristic (ROC) curve analyses (p = 0.001). Based on our findings, a lower %fPSA, especially <10%, is an important parameter when deciding whether to perform a biopsy on patients with a tPSA between 2.5 ng/mL and 10 ng/mL. Copyright © 2015. Published by Elsevier Taiwan.

  14. Depression Screening

    Science.gov (United States)

    ... Depression Screening Substance Abuse Screening Alcohol Use Screening Depression Screening (PHQ-9) - Instructions The following questions are ... this tool, there is also text-only version . Depression Screening - Manual Instructions The following questions are a ...

  15. The New Planetary Science Archive (PSA): Exploration and Discovery of Scientific Datasets from ESA's Planetary Missions

    Science.gov (United States)

    Heather, David; Besse, Sebastien; Vallat, Claire; Barbarisi, Isa; Arviset, Christophe; De Marchi, Guido; Barthelemy, Maud; Coia, Daniela; Costa, Marc; Docasal, Ruben; Fraga, Diego; Grotheer, Emmanuel; Lim, Tanya; MacFarlane, Alan; Martinez, Santa; Rios, Carlos; Vallejo, Fran; Saiz, Jaime

    2017-04-01

    The Planetary Science Archive (PSA) is the European Space Agency's (ESA) repository of science data from all planetary science and exploration missions. The PSA provides access to scientific datasets through various interfaces at http://psa.esa.int. All datasets are scientifically peer-reviewed by independent scientists, and are compliant with the Planetary Data System (PDS) standards. The PSA is currently implementing a number of significant improvements, mostly driven by the evolution of the PDS standard, and the growing need for better interfaces and advanced applications to support science exploitation. As of the end of 2016, the PSA is hosting data from all of ESA's planetary missions. This includes ESA's first planetary mission Giotto that encountered comet 1P/Halley in 1986 with a flyby at 800km. Science data from Venus Express, Mars Express, Huygens and the SMART-1 mission are also all available at the PSA. The PSA also contains all science data from Rosetta, which explored comet 67P/Churyumov-Gerasimenko and asteroids Steins and Lutetia. The year 2016 has seen the arrival of the ExoMars 2016 data in the archive. In the upcoming years, at least three new projects are foreseen to be fully archived at the PSA. The BepiColombo mission is scheduled for launch in 2018. Following that, the ExoMars Rover Surface Platform (RSP) in 2020, and then the JUpiter ICy moon Explorer (JUICE). All of these will archive their data in the PSA. In addition, a few ground-based support programmes are also available, especially for the Venus Express and Rosetta missions. The newly designed PSA will enhance the user experience and will significantly reduce the complexity for users to find their data promoting one-click access to the scientific datasets with more customized views when needed. This includes a better integration with Planetary GIS analysis tools and Planetary interoperability services (search and retrieve data, supporting e.g. PDAP, EPN-TAP). It will also be up

  16. Message from Jimmy Smits: La Vida Real PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message in Spanish from actor Jimmy Smits about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  17. Message from Jimmy Smits: La Vida Real PSA (:20)

    Centers for Disease Control (CDC) Podcasts

    2010-04-13

    A message in Spanish from actor Jimmy Smits about the importance of screening for colorectal cancer.  Created: 4/13/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 4/13/2010.

  18. Clinical Application of Screening for GJB2 Mutations before Cochlear Implantation in a Heterogeneous Population with High Rate of Autosomal Recessive Nonsyndromic Hearing Loss

    Directory of Open Access Journals (Sweden)

    Masoud Motasaddi Zarandy

    2011-01-01

    Full Text Available Clinical application of mutation screening and its effect on the outcome of cochlear implantation is widely debated. We investigated the effect of mutations in GJB2 gene on the outcome of cochlear implantation in a population with a high rate of consanguineous marriage and autosomal recessive nonsyndromic hearing loss. Two hundred and one children with profound prelingual sensorineural hearing loss were included. Forty-six patients had 35delG in GJB2. Speech awareness thresholds (SATs and speech recognition thresholds (SRTs improved following implantation, but there was no difference in performance between patients with GJB2-related deafness versus control (all >0.10. Both groups had produced their first comprehensible words within the same period of time following implantation (2.27 months in GJB2-related deaf versus 2.62 months in controls, =0.22. Although our findings demonstrate the need to uncover unidentified genetic causes of hereditary deafness, they do not support the current policy for genetic screening before cochlear implantation, nor prove a prognostic value.

  19. Proteins Annexin A2 and PSA in Prostate Cancer Biopsies Do Not Predict Biochemical Failure.

    Science.gov (United States)

    Lamb, David S; Sondhauss, Sven; Dunne, Jonathan C; Woods, Lisa; Delahunt, Brett; Ferguson, Peter; Murray, Judith; Nacey, John N; Denham, James W; Jordan, T William

    2017-12-01

    We previously reported the use of mass spectrometry and western blotting to identify proteins from tumour regions of formalin-fixed paraffin-embedded biopsies from 16 men who presented with apparently localized prostate cancer, and found that annexin A2 (ANXA2) appeared to be a better predictor of subsequent biochemical failure than prostate-specific antigen (PSA). In this follow-up study, ANXA2 and PSA were measured using western blotting of proteins extracted from biopsies from 37 men from a subsequent prostate cancer trial. No significant differences in ANXA2 and PSA levels were observed between men with and without biochemical failure. The statistical effect sizes were small, d=0.116 for ANXA2, and 0.266 for PSA. ANXA2 and PSA proteins measured from biopsy tumour regions are unlikely to be good biomarkers for prediction of the clinical outcome of prostate cancer presenting with apparently localized disease. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  20. Long-term clinical impact of PSA surge in castration-resistant prostate cancer patients treated with abiraterone.

    Science.gov (United States)

    Conteduca, Vincenza; Caffo, Orazio; Lolli, Cristian; Aieta, Michele; Scarpi, Emanuela; Bianchi, Emanuela; Maines, Francesca; Schepisi, Giuseppe; Salvi, Samanta; Massari, Francesco; Carrozza, Francesco; Veccia, Antonello; Chiuri, Vincenzo E; Campadelli, Enrico; Facchini, Gaetano; De Giorgi, Ugo

    2017-06-01

    Early changes in PSA have been evaluated in association to treatment outcome. The aim of this study was to assess PSA surge phenomenon in castration-resistant prostate cancer (CRPC) patients treated with abiraterone and to correlate those variations with long-term treatment outcome. We retrospectively evaluated 330 CRPC patients in 11 Italian hospitals, monitoring PSA levels at baseline and every 4 weeks. Other clinical, biochemical and molecular parameters were determined at baseline. We considered PSA surge as PSA increase within the first 8 weeks from starting abiraterone more than 1% from baseline followed by a PSA decline. The log-rank test was applied to compare survival between groups of patients according to PSA surge. The impact of PSA surge on survival was evaluated by Cox regression analyses. A total of 330 patients with CRPC, median age 74 years (range, 45-90), received abiraterone (281 chemotherapy-treated and 49 chemotherapy-naïve). PSA surge was observed in 20 (7%) post-chemotherapy and 2 (4%) chemotherapy-naïve patients. For overall patients presenting PSA surge, timing of PSA peak from baseline was 5 ± 1.8 weeks and PSA rise from baseline was 21 ± 18.4%. The overall median follow-up was 23 months (range 1-62). No significant differences in progression-free survival and overall survival were observed between patients with and without PSA surge (P = 0.16 and =0.86, respectively). In addition, uni- and multivariate analyses showed no baseline factors related to PSA surge. PSA surge occurs in both chemotherapy-treated and chemotherapy-naïve patients treated with abiraterone resulting, however, in no long-term impact on outcome. Physicians and patients should be aware of PSA surge challenge to prevent a premature discontinuation of potentially effective therapy with abiraterone. Further larger and prospective studies are warranted to investigate this not infrequent phenomenon. © 2017 Wiley Periodicals, Inc.

  1. The preoperative serum ratio of total prostate specific antigen (PSA to free testosterone (FT, PSA/FT index ratio, and prostate cancer. Results in 220 patients undergoing radical prostatectomy

    Directory of Open Access Journals (Sweden)

    Antonio B. Porcaro

    2016-03-01

    Full Text Available Objectives: To evaluate associations of preoperative total prostate specific antigen (PSA to free testosterone (FT, the PSA/FT index ratio, with features of pathology prostate cancer (PCA and to investigate its prognostic potential in clustering the PCA population. Patients and methods: After excluding criteria, the records of 220 patients who underwent radical prostatectomy (RP were retrospectively reviewed. Serum samples of PSA, total testosterone (TT and FT were collected at 8.00 A.M., one month after biopsies and before RP. The PSA/FT ratio was computed in the population of patients who were clustered in groups according to ranking intervals of the PSA/FT ratio which identified at least 4 clusters which were coded as A, B, C, and D. The independent associations of the PSA/FT index ratio were assessed by statistical methods and a two-sided P < 0.05 was considered to indicate statistical significance. Results: TT correlated to FT which was a significant predictor of PSA in the population of patients who were subsequently clustered, according to increasing interval values of the PSA/FT index ratio, in groups that showed a stronger linear association of FT with PSA. The PSA/FT index ratio significantly associated with pathology features of prostate cancer such as pathology Gleason score (pGS, invasion of the seminal vesicles (pT3b, proportion of positive cores (P+ and proportion of cancer involving the volume of the prostate. In the population of patients, TT, PSA/FT index ratio and P+ independently associated with pGS ≥ 7 and pT3b; moreover, the odds ratio (OR of the PSA/FT index ratio resulted 9.11 which was stronger than TT (OR = 1.11 and P+ (OR = 8.84. In the PCA population, TT, PSA/FT index ratio and P+ also independently associated with pT3b PCA; interestingly, the OR of PSA/FT index resulted 54.91 which was stronger than TT (OR = 1.31 and P+ (26.43. Conclusions: Preoperative PSA/FT index ratio is an independent strong factor which

  2. The preoperative serum ratio of total prostate specific antigen (PSA) to free testosterone (FT), PSA/FT index ratio, and prostate cancer. Results in 220 patients undergoing radical prostatectomy.

    Science.gov (United States)

    Porcaro, Antonio B; Caruso, Beatrice; Terrin, Alessandro; De Luyk, Nicolò; Cacciamani, Giovanni; Corsi, Paolo; Inverardi, Davide; De Marchi, Davide; Baldassarre, Roberto; Cerruto, Mariangela; Ghimenton, Claudio; Brunelli, Matteo; Zecchini Antoniolli, Stefano; Petrozziello, Aldo; Artibani, Walter

    2016-03-31

    To evaluate associations of preoperative total prostate specific antigen (PSA) to free testosterone (FT), the PSA/FT index ratio, with features of pathology prostate cancer (PCA) and to investigate its prognostic potential in clustering the PCA population. After excluding criteria, the records of 220 patients who underwent radical prostatectomy (RP) were retrospectively reviewed. Serum samples of PSA, total testosterone (TT) and FT were collected at 8.00 A.M., one month after biopsies and before RP. The PSA/FT ratio was computed in the population of patients who were clustered in groups according to ranking intervals of the PSA/FT ratio which identified at least 4 clusters which were coded as A, B, C, and D. The independent associations of the PSA/FT index ratio were assessed by statistical methods and a two-sided P < 0.05 was considered to indicate statistical significance. TT correlated to FT which was a significant predictor of PSA in the population of patients who were subsequently clustered, according to increasing interval values of the PSA/FT index ratio, in groups that showed a stronger linear association of FT with PSA. The PSA/FT index ratio significantly associated with pathology features of prostate cancer such as pathology Gleason score (pGS), invasion of the seminal vesicles (pT3b), proportion of positive cores (P+) and proportion of cancer involving the volume of the prostate. In the population of patients, TT, PSA/FT index ratio and P+ independently associated with pGS ≥ 7 and pT3b; moreover, the odds ratio (OR) of the PSA/FT index ratio resulted 9.11 which was stronger than TT (OR = 1.11) and P+ (OR = 8.84). In the PCA population, TT, PSA/FT index ratio and P+ also independently associated with pT3b PCA; interestingly, the OR of PSA/FT index resulted 54.91 which was stronger than TT (OR = 1.31) and P+ (26.43). Preoperative PSA/FT index ratio is an independent strong factor which directly associates with aggressive features of pathology PCA

  3. Study of possibility using LANL PSA-methodology for accident probability RBMK researches

    Energy Technology Data Exchange (ETDEWEB)

    Petrin, S.V.; Yuferev, V.Y.; Zlobin, A.M.

    1995-12-31

    The reactor facility probabilistic safety analysis methodologies are considered which are used at U.S. LANL and RF NIKIET. The methodologies are compared in order to reveal their similarity and differences, determine possibilities of using the LANL technique for RBMK type reactor safety analysis. It is found that at the PSA-1 level the methodologies practically do not differ. At LANL the PHA, HAZOP hazards analysis methods are used for more complete specification of the accounted initial event list which can be also useful at performance of PSA for RBMK. Exchange of information regarding the methodology of detection of dependent faults and consideration of human factor impact on reactor safety is reasonable. It is accepted as useful to make a comparative study result analysis for test problems or PSA fragments using various computer programs employed at NIKIET and LANL.

  4. Polymorphisms in the AR and PSA genes as markers of susceptibility and aggressiveness in prostate cancer

    DEFF Research Database (Denmark)

    Kuasne, Hellen; Rodrigues, Iara Sant'Ana; Fuganti, Paulo Emílio

    2010-01-01

    The study of genes involved in androgen pathway can contribute to a better knowledge of prostate cancer. Our aim was to examine if polymorphisms in prostate-specific antigen (PSA) and androgen receptor (AR) genes were involved in prostate cancer risk and aggressiveness. Genotypes were determined...... by PCR-RFLP (PSA) or using a 377 ABI DNA Sequencer (AR). PSA(G/G) genotype (OR = 1.78, 95% CI = 1.06–2.99) and AR short CAG repeats (OR = 1.89, 95% CI = 1.21–2.96) increased risk for prostate cancer and were related with tumor aggressiveness. About 38.3% of tumors showed microsatellite instability...

  5. Positive surgical margins at radical prostatectomy: Population-based averages within PSA and Gleason strata.

    Science.gov (United States)

    Izard, Jason P; Salazar, Marco A; Chatterjee, Suman; Lin, Daniel W; Wright, Jonathan L

    2013-01-01

    Positive surgical margins (PSM) are an important determinant of biochemical recurrence after radical prostatectomy (RP). We use a population-based cancer registry to evaluate PSM by stage, Gleason and prostate-specific antigen (PSA). We identified men undergoing RP from the Surveillance, Epidemiology and End Results (SEER) database between 2004 and 2007. Differences between those with and without PSM were compared with chi-squared tests. The proportion of cases with PSM were stratified by PSA and Gleason sum for both pT2 and pT3a tumours. Factors associated with PSM were analyzed using chi square and multivariate logistic regression analysis. A composite variable was used in a second multivariate analysis to display the odds ratio (OR) for a PSM for each discrete combination of PSA, Gleason score and pT stage. In total, 28 461 RP patients were identified and a PSM was present in 19.5%. PSM were 42% in pT3a and 16% in pT2 cases. Higher PSAs (10) were associated with higher proportions of PSM (12%, 20% and 28%, p strata compared to those with pT2 tumours, reaching 63% for those with pT3a, Gleason 8-10, PSA >10 disease. On multivariate analysis, stage was the largest predictor for PSM (OR 3.05, 95% confidence interval 2.81-3.30), although Gleason score and PSA remained statistically significant. In this population-based study of PSM after RP, the proportion of PSM vary significantly within different PSA and Gleason strata for organ-confined and extracapsular disease. These data can be used as a reference for urologist self-assessment.

  6. Literature Survey on Technical Issues and Insights of Multi-Unit PSA

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Sejin; Park, Soyoung; Heo, Gyunyoung [Kyung Hee Univ., Yongin (Korea, Republic of)

    2016-10-15

    The need consider the risk impact in case of multi-unit in a single site increased after the accident at Fukushima Daiichi in March 2011. This means that we have to consider the single-unit initiators impacting the other units and the simultaneous accidents of the multi-unit on the same site. Particularly, this kind of technical concern is serious in case of the Republic of Korea where multi-units had to be located in high-density population area due to geographical features. The Nuclear Safety and Security Commission (NSSC) in the Republic of Korea has been trying to identify the state of the art of international and domestic regulations and techniques on multi-unit risk assessment and planning the road map for the safety researches. However, we have to say that finding a common accepted methodology along with safety criteria for multi-unit PSA was not an easy task up to now. This paper summarizes and analyzes related international and domestic journals' papers, conferences' papers and reports about the multi-unit PSA classifying categories with themes to understand the technical tendency of multi-unit PSA. In addition, some insights that were obtained from this classification have been arranged too. This paper investigated the technical trend of the multi-unit PSA as collecting of the international and domestic journals' papers, conferences papers and reports, and analyzing them. Upon the literature survey, a few statistics, technical issues, and insights were summarized. Both of the fundamental and practical researches need to find a globally accepted methodology to calculate and determine quantitative objectives for a multi-unit PSA. We want to expect that this paper can be shared to understand the current status of multi-unit PSA.

  7. Mammographic screening programmes in Europe

    DEFF Research Database (Denmark)

    Giordano, Livia; von Karsa, Lawrence; Tomatis, Mariano

    2012-01-01

    To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe.......To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe....

  8. Prostate-Specific Antigen at 4 to 5 Years After Low-Dose-Rate Prostate Brachytherapy Is a Strong Predictor of Disease-Free Survival

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Andrea C. [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Morris, W. James, E-mail: JMorris@bccancer.bc.ca [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Lapointe, Vincent [Department of Medical Physics, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Hamm, Jeremy [Department of Population Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Keyes, Mira; Pickles, Tom; McKenzie, Michael [Department of Radiation Oncology, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada); Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Spadinger, Ingrid [Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia (Canada); Department of Medical Physics, British Columbia Cancer Agency Vancouver Centre, Vancouver, British Columbia (Canada)

    2014-01-01

    Purpose: To determine (1) the prognostic utility of prostate-specific antigen (PSA) concentration at 45 to 60 months (48mPSA) after low-dose-rate prostate brachytherapy (LDR-PB); (2) the predictors of 48mPSA; and (3) the prognostic utility of directional trends between PSA levels at 24, 36, and 48 months after LDR-PB. Methods and Materials: Between 1998 and 2008, 2223 patients with low- and intermediate-risk prostate cancer received LDR-PB monotherapy. A cohort of 1434 of these patients was identified with a documented 48mPSA and no evidence of disease relapse prior to the 48mPSA. In addition, a subset of this cohort (n=585) was identified with ≥72 months of follow-up and documented PSA values at both 24 and 36 months after implantation. Results: Median follow-up time was 76 months. Eight-year Kaplan-Meier disease-free survival (DFS) rates were 100% vs 73.4% for patients with 48mPSA ≤0.2 vs those with >0.2 ng/mL; 99.1% versus 53.8% for a 48mPSA threshold of ≤0.4 versus >0.4 ng/mL, respectively; and 97.3% versus 0% for a threshold of ≤1.0 versus >1.0 ng/mL, respectively. On multivariate analysis, the only factor predictive of DFS was 48mPSA (P<.0001). On subset analysis (n=585), 29 patients had a PSA rise (defined as >0.2 ng/mL) between 24 and 36 months, 24 patients had a rise between 36 and 48 months, and 11 patients had rises over both intervals. Failure rates in these patients were 52%, 79%, and 100%, respectively. On multivariate analysis, initial PSA, androgen deprivation therapy, and dose to 90% of the prostate significantly correlated with 48mPSA but together accounted for only ∼5% of its total variance. Conclusions: The 48mPSA after LDR-PB is highly predictive of long-term DFS. Patients with 48mPSA ≤0.4 ng/mL had a <1% risk of disease relapse at 8 years, whereas all patients with 48mPSA >1.0 ng/mL relapsed. Consecutive PSA rises of >0.2 ng/mL from 24 to 36 months and from 36 to 48 months were also highly predictive of subsequent failure.

  9. Adult ADHD screening in alcohol-dependent patients using the Wender-Utah Rating Scale and the adult ADHD Self-Report Scale.

    Science.gov (United States)

    Daigre, Constanza; Roncero, Carlos; Rodríguez-Cintas, Laia; Ortega, Lluisa; Lligoña, Anna; Fuentes, Sonia; Pérez-Pazos, Jesús; Martínez-Luna, Nieves; Casas, Miguel

    2015-04-01

    The aim was to analyze the psychometric properties of two screening instruments, Wender-Utah Rating Scale (WURS) that evaluates childhood ADHD and Adult ADHD Self-Report Scales (ASRS) that assesses symptoms in adulthood, in alcohol-dependent patients. A total of 355 outpatients were included. Conners' adult ADHD diagnostic interview results were used as a gold standard in childhood and adulthood ADHD. The WURS with a 41 cutoff had a sensitivity of 79.6% and a specificity of 60.3%. The ASRS with a 14 cutoff had a sensitivity of 86.7% and specificity of 66.1%. Analyzing both rating scales in combination, it was observed that patients with positive ASRS and WURS presented a sensitivity of 92.3%. Patients with positive ASRS, but negative WURS, presented a specificity of 73.6%. WURS and ASRS are useful tools in the diagnosis of adult ADHD in alcohol-dependent patients; with the use of both instruments, the psychometric properties are substantially improved. © 2014 SAGE Publications.

  10. Outcome of laterally directed sextant biopsies of the prostate in screened males aged 50--66 years. Implications for sampling order.

    Science.gov (United States)

    Aus, G; Bergdahl, S; Hugosson, J; Lodding, P; Pihl, C G; Pileblad, E

    2001-06-01

    Prostate cancer has its most frequent location in the posterior-lateral part of the gland. The aim of this study was to evaluate the cancer detection rate of six systemic prostate biopsies with mid lobar biopsies taken far laterally in the prostate. A total of 692 patients (aged 50--66 years) enrolled in a screening study underwent prostate biopsies because of an elevated serum prostate-specific antigen (PSA; > or =3 ng/ml) level. The outcome of the biopsies was related to findings at digital rectal examination (DRE) and transrectal ultrasound (TRUS) and to the location within the prostate. Prostate cancer was detected in 164 patients. DRE and TRUS were suspicious of malignancy in 66 cases (40%) and 84 cases (51%), respectively. The two biopsies taken far laterally midlobar in the prostate detected as many as 83% of the cancers and when combined with two apical biopsies, 96% of all cancers were detected. At PSA screening in this age-group, only 57% of the prostate cancers detectable by sextant biopsies were palpable or visible at TRUS. Most of the cancers (96%) were detectable by only four systematic, carefully directed biopsies. In men with normal DRE, the two lateral midlobar biopsies should be taken first during the biopsy procedure.

  11. Combination of prostate imaging reporting and data system (PI-RADS) score and prostate-specific antigen (PSA) density predicts biopsy outcome in prostate biopsy naïve patients.

    Science.gov (United States)

    Washino, Satoshi; Okochi, Tomohisa; Saito, Kimitoshi; Konishi, Tsuzumi; Hirai, Masaru; Kobayashi, Yutaka; Miyagawa, Tomoaki

    2017-02-01

    To assess the value of the Prostate Imaging Reporting and Data System (PI-RADS) scoring system, for prostate multi-parametric magnetic resonance imaging (mpMRI) to detect prostate cancer, and classical parameters, such as prostate-specific antigen (PSA) level, prostate volume and PSA density, for predicting biopsy outcome in biopsy naïve patients who have suspected prostate cancer. Patients who underwent mpMRI at our hospital, and who had their first prostate biopsy between July 2010 and April 2014, were analysed retrospectively. The prostate biopsies were taken transperineally under transrectal ultrasonography guidance. In all, 14 cores were biopsied as a systematic biopsy in all patients. Two cognitive fusion-targeted biopsy cores were added for each lesion in patients who had suspicious or equivocal lesions on mpMRI. The PI-RADS scoring system version 2.0 (PI-RADS v2) was used to describe the MRI findings. Univariate and multivariate analyses were performed to determine significant predictors of prostate cancer and clinically significant prostate cancer. In all, 288 patients were analysed. The median patient age, PSA level, prostate volume and PSA density were 69 years, 7.5 ng/mL, 28.7 mL, and 0.26 ng/mL/mL, respectively. The biopsy results were benign, clinically insignificant, and clinically significant prostate cancer in 129 (45%), 18 (6%) and 141 (49%) patients, respectively. The multivariate analysis revealed that PI-RADS v2 score and PSA density were independent predictors for prostate cancer and clinically significant prostate cancer. When PI-RADS v2 score and PSA density were combined, a PI-RADS v2 score of ≥4 and PSA density ≥0.15 ng/mL/mL, or PI-RADS v2 score of 3 and PSA density of ≥0.30 ng/mL/mL, was associated with the highest clinically significant prostate cancer detection rates (76-97%) on the first biopsy. Of the patients in this group with negative biopsy results, 22% were subsequently diagnosed as prostate cancer. In contrast, a PI

  12. PSA testing for prostate cancer: an online survey of the views and reported practice of General Practitioners in the UK.

    NARCIS (Netherlands)

    Brett, J.; Watson, E.; Hewitson, P.; Bukach, C.; Edwards, A.; Elwyn, G.; Austoker, J.

    2005-01-01

    BACKGROUND: The role of Prostate Specific Antigen (PSA) testing in the early detection of prostate cancer is controversial. Current UK policy stipulates that any man who wishes to have a PSA test should have access to the test, provided he has been given full information about the benefits and

  13. Association of GPs' risk attitudes, level of empathy, and burnout status with PSA testing in primary care

    DEFF Research Database (Denmark)

    Pedersen, Anette F; Carlsen, Anders H; Vedsted, Peter

    2015-01-01

    Denne artikel undersøger, om variationen i raten af PSA-tests mellem alment praktiserende læger kan forklares af psykologiske faktorer som f.eks. lægens risikovillighed. Resultaterne viser, at lægens risikovillighed influerer på raten af PSA-tests. Forfatterne finder blandt andet, at patienter, s...

  14. The low molecular weight protein PsaI stabilizes the light-harvesting complex II docking site of photosystem I

    DEFF Research Database (Denmark)

    Plöchinger, Magdalena; Torabi, Salar; Rantala, Marjaana

    2016-01-01

    PsaI represents one of three low molecular weight peptides of PSI. Targeted inactivation of the plastid PsaI gene in Nicotiana tabacum has no measurable effect on photosynthetic electron transport around PSI or on accumulation of proteins involved in photosynthesis. Instead, the lack of PsaI dest...... of mutant plants into state 2 in darkness represents a compensatory and/or protective metabolic mechanism. This involves an increased reduction and/or reduced oxidation of the PQ pool, presumably to sustain a balanced excitation of both photosystems upon the onset of light.......PsaI represents one of three low molecular weight peptides of PSI. Targeted inactivation of the plastid PsaI gene in Nicotiana tabacum has no measurable effect on photosynthetic electron transport around PSI or on accumulation of proteins involved in photosynthesis. Instead, the lack of Psa......I destabilizes the association of PsaL and PsaH to PSI, both forming the light-harvesting complex (LHC)II docking site of PSI. These alterations at the LHCII binding site surprisingly did not prevent state transition but led to an increased incidence of PSI-LHCII complexes, coinciding with an elevated...

  15. Reduction in uptake of PSA tests following decision aids: systematic review of current aids and their evaluations.

    NARCIS (Netherlands)

    Evans, R.; Edwards, A.; Brett, J.; Bradburn, M.; Watson, E.; Austoker, J.; Elwyn, G.

    2005-01-01

    A man's decision to have a prostate-specific antigen (PSA) test should be an informed one. We undertook a systematic review to identify and appraise PSA decision aids and evaluations. We searched 15 electronic databases and hand-searched key journals. We also contacted key authors and organisations.

  16. Immediate treatment with bicalutamide 150mg as adjuvant therapy significantly reduces the risk of PSA progression in early prostate cancer

    DEFF Research Database (Denmark)

    See, W; Iversen, P; Wirth, M

    2003-01-01

    To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer.......To evaluate the effect of bicalutamide ('Casodex') 150mg (in addition to standard care), on the risk of prostate-specific antigen (PSA) progression, in patients with early prostate cancer....

  17. Sensitivity of HOXB13 as a Diagnostic Immunohistochemical Marker of Prostatic Origin in Prostate Cancer Metastases: Comparison to PSA, Prostein, Androgen Receptor, ERG, NKX3.1, PSAP, and PSMA

    Directory of Open Access Journals (Sweden)

    Ilka Kristiansen

    2017-05-01

    Full Text Available Aims: Determining the origin of metastases is an important task of pathologists to allow for the initiation of a tumor-specific therapy. Recently, homeobox protein Hox-B13 (HOXB13 has been suggested as a new marker for the detection of prostatic origin. The aim of this study was to evaluate the diagnostic sensitivity of HOXB13 in comparison to commonly used immunohistochemical markers for prostate cancer. Materials and methods: Histologically confirmed prostate cancer lymph node metastases from 64 cases were used to test the diagnostic value of immunohistochemical markers: prostate specific antigen (PSA, Prostatic acid phosphatase (PSAP, prostate specific membrane antigen (PSMA, homeobox gene NKX3.1, prostein, androgen receptor (AR, HOXB13, and ETS-related gene (ERG. All markers were evaluated semi-quantitatively using Remmele's immune reactive score. Results: The detection rate of prostate origin of metastasis for single markers was 100% for NKX3.1, 98.1% for AR, 84.3% for PSMA, 80.8% for PSA, 66% for PSAP, 60.4% for HOXB13, 59.6% for prostein, and 50.0% for ERG. Conclusions: Our data suggest that HOXB13 on its own lacks sensitivity for the detection of prostatic origin. Therefore, this marker should be only used in conjunction with other markers, preferably the highly specific PSA. The combination of PSA with NKX3.1 shows a higher sensitivity and thus appears preferable in this setting.

  18. Understanding the Harms and Benefits of Cancer Screening: A Model of Factors That Shape Informed Decision Making.

    Science.gov (United States)

    Petrova, Dafina; Garcia-Retamero, Rocio; Cokely, Edward T

    2015-10-01

    Decisions about cancer screenings often involve the consideration of complex and counterintuitive evidence. We investigated psychological factors that promote the comprehension of benefits and harms associated with common cancer screenings and their influence on shared decision making. In experiment 1, 256 men received information about PSA-based prostate cancer screening. In experiment 2, 355 women received information about mammography-based breast cancer screening. In both studies, information about potential screening outcomes was provided in 1 of 3 formats: text, a fact box, or a visual aid (e.g., mortality with and without screening and rate of overdiagnosis). We modeled the interplay of comprehension, perceived risks and benefits, intention to participate in screening, and desire for shared decision making. Generally, visual aids were the most effective format, increasing comprehension by up to 18%. Improved comprehension was associated with 1) superior decision making (e.g., fewer intentions to participate in screening when it offered no benefit) and 2) more desire to share in decision making. However, comprehension of the evidence had a limited effect on experienced emotions, risk perceptions, and decision making among those participants who felt that the consequences of cancer were extremely severe. Even when information is counterintuitive and requires the integration of complex harms and benefits, user-friendly risk communications can facilitate comprehension, improve high-stakes decisions, and promote shared decision making. However, previous beliefs about the effectiveness of screening or strong fears about specific cancers may interfere with comprehension and informed decision making. © The Author(s) 2015.

  19. Lowering bronchoaspiration rate in an acute stroke unit by means of a 2 volume/3 texture dysphagia screening test with pulsioximetry.

    Science.gov (United States)

    Cocho, D; Sagales, M; Cobo, M; Homs, I; Serra, J; Pou, M; Perez, G; Pujol, G; Tantinya, S; Bao, P; Aloy, A; Sabater, R; Gendre, J; Otermin, P

    During acute stroke, 30% of all patients present dysphagia and 50% of that subgroup will experience bronchoaspiration. Our aim was to compare mortality and bronchoaspiration rates associated with the water test compared to those associated with a 2 volume/3 texture test controlled with pulse oximetry (2v/3t-P test) in our stroke unit. Over a 5-year period, we performed a prospective analysis of all consecutive acute ischaemic stroke patients hospitalised in the Stroke Unit. Dysphagia was evaluated using the water test between 2008 and 2010 (group 0 or G0), and the 2v/3t-P test (group 1 or G1) between 2011 and 2012. We analysed demographic data, vascular risk factors, neurological deficit on the NIHSS, aetiological subtype according to TOAST criteria, clinical subtype according to the Oxfordshire classification, prevalence of dysphagia, percentage of patients with bronchoaspiration, and mortality. We examined 418 patients with acute stroke (G0=275, G1=143). There were significant differences between the 2 groups regarding the percentage of patients with TACI (17% in G0 vs. 29% in G1, P=.005) and median NIHSS score (4 points in G0 vs. 7 points in G1, P=.003). Since adopting the new swallowing test, we detected a non-significant increase in the percentage of dysphagia (22% in G0 vs. 25% in G1, P=.4), lower mortality (1.7% in G0 vs. 0.7% in G1, P=.3) and a significant decrease in the bronchoaspiration rate (6.2% in G0 vs. 2.1% in G1, P=.05). Compared to the water test used for dysphagia screening, the new 2v/3t-P test lowered bronchoaspiration rates in acute stroke patients. Copyright © 2014 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. PSA e medidas antropométricas em índios da Amazônia: avaliação da comunidade Parkatejê PSA and anthropometric measurements among Amazon Indians: an evaluation of the Parkatejê community

    Directory of Open Access Journals (Sweden)

    Homero Oliveira de Arruda

    2003-10-01

    Full Text Available OBJETIVO: O rastreamento com o PSA (antígeno prostático específico para detecção precoce de câncer de próstata em uma comunidade nativa tem grande importância epidemiológica. Assim, realizou-se estudo com objetivo de verificar a ocorrência do câncer da próstata em uma tribo indígena da Amazônia e uma possível relação entre o aculturamento, a presença de sobrepeso (índice de massa corporal e o aparecimento da doença. MÉTODOS: Foi realizado um levantamento dos hábitos e medidas antropométricas em 22 homens com idade presumida maior de 50 anos, de uma tribo isolada de 363 índios, autodenominados Parkatejê e Kikatêjê, vivendo na região Amazônica (Pará. Além dos exames físico e hematológicos, foram realizadas dosagens de PSA total e PSA livre. RESULTADO: Os níveis séricos de PSA total variaram de 0,35 a 25,8 ng/ml. Três nativos apresentaram PSA maior que 4,0 ng/ml e outros dois evidenciaram PSA entre 2,5 e 4,0 ng/ml. Biopsia prostática em dois nativos revelou a presença de adenocarcinoma de próstata em um e neoplasia intraepitelial em outro. Sobrepeso com índice de massa corporal >25 Kg/m² e relação cintura-quadril >0,9 foram observados em 68,1% e 72,7% do grupo estudado. CONCLUSÕES: Mudanças nutricionais decorrentes do contato com a civilização, como substituição da caça e fibras vegetais por alimentos mais calóricos, estão aumentando a freqüência de sobrepeso na comunidade indígena. Devido à associação entre incidência de câncer de próstata, dieta gordurosa e menor atividade física, pode-se presumir que o futuro testemunhará mais casos da neoplasia prostática, visto que vários de seus membros já evidenciaram altos níveis séricos de PSA.OBJECTIVE: PSA (prostate-specific antigen screening for early detection of prostate cancer in a native community is of great epidemiological importance. The study was conducted with the objective of verifying the occurrence of prostate cancer among

  1. Perceptions of prostate cancer fatalism and screening behavior between United States-born and Caribbean-born Black males.

    Science.gov (United States)

    Cobran, Ewan K; Wutoh, Anthony K; Lee, Euni; Odedina, Folakemi T; Ragin, Camille; Aiken, William; Godley, Paul A

    2014-06-01

    Cancer fatalism is believed to be a major barrier for cancer screening in Black males. Therefore, the purpose of this study was to compare perceptions of prostate cancer (CaP) fatalism and predictors of CaP screening with Prostate Specific Antigen (PSA) testing between U.S.-born and Caribbean-born Black males. The Powe Fatalism Inventory and the Personal Integrative Model of CaP Disparity Survey were used to collect the following data from males in South Florida. Multivariate logistic regression models were constructed to examine the statistically significant predictors of CaP screening. A total of 211 U.S.-born and Caribbean-born Black males between ages 39-75 were recruited. Nativity was not a significant predictor of CaP screening with PSA testing within the last year (Odds ratio [OR] = 0.80, 95% confidence interval [CI] = 0.26, 2.48, p = 0.70). Overall, higher levels of CaP fatalism were not a significant predictor of CaP screening with PSA testing within the last year (OR = 1.37, 95% CI = 0.48, 3.91, p = 0.56). The study results suggest that nativity did not influence CaP screening with PSA testing. However, further studies are needed to evaluate the association between CaP screening behavior and levels of CaP fatalism.

  2. Study on communicating risk information obtained from PSA within nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Nunogane, Nobuaki; Onoue, Akira [Institute of Nuclear Technology, Institute of Nuclear Safety System, Inc., Mihama, Fukui (Japan); Kojima, Shigeo [Computer Software Development Corp., Tokyo(Japan)

    2000-09-01

    In this study, the communication of PSA information in nuclear power plants (NPPs), namely, how the risk information obtained from the probabilistic safety assessment (PSA) should be presented and communicated to plant personnel, was examined assuming that the safety management system based on the risk information was introduced to NPPs. This is called PSA communication. First, when risk-informed safety management is to be introduced into NPPs, plant personnel should have sufficient related knowledge. In order to provide such knowledge to the personnel through training, risk information is classified into three types: basic information, detailed information and task information. A hierarchical risk information summary for reporting, coordinating and communicating tasks is proposed. In this summary, the concerns of those who have received the information are placed at the top and the related risk information positioned below. At the same time, and by way of a trial, the risk information relating to on-line maintenance (OLM) is prepared. In order to enhance the safety-consciousness and the safety of the entire plant, specific plans such as 'risk tags' which indicate the safety significance of equipment is proposed. Finally, a guideline providing examination procedures for developing detailed PSA communication plans is introduced. (author)

  3. Tools Related to the Federal Tobacco Products Regulations: What Retailers Need to Know PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-09-16

    PSA to announce a new mobile text message program that will help raise retailers' awareness of the new federal tobacco regulations.  Created: 9/16/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 9/16/2010.

  4. IMPROVEMENT OF THE LOCA PSA MODEL USING A BEST-ESTIMATE THERMAL-HYDRAULIC ANALYSIS

    Directory of Open Access Journals (Sweden)

    DONG HYUN LEE

    2014-08-01

    Full Text Available Probabilistic Safety Assessment (PSA has been widely used to estimate the overall safety of nuclear power plants (NPP and it provides base information for risk informed application (RIA and risk informed regulation (RIR. For the effective and correct use of PSA in RIA/RIR related decision making, the risk estimated by a PSA model should be as realistic as possible. In this work, a best-estimate thermal-hydraulic analysis of loss-of-coolant accidents (LOCAs for the Hanul Nuclear Units 3&4 is first carried out in a systematic way. That is, the behaviors of peak cladding temperature (PCT were analyzed with various combinations of break sizes, the operating conditions of safety systems, and the operator's action time for aggressive secondary cooling. Thereafter, the results of the thermal-hydraulic analysis have been reflected in the improvement of the PSA model by changing both accident sequences and success criteria of the event trees for the LOCA scenarios.

  5. Student-Designed Public Service Announcement (PSA) Videos to Enhance Motivation and Engagement

    Science.gov (United States)

    Abrams, Kenneth

    2012-01-01

    Educators often focus on enhancing student motivation and engagement. This article describes an activity with these aims, in which undergraduates (a) learn about theories and research on means of persuasion and (b) in small groups design and record a public service announcement (PSA) video, write a brief paper that outlines the theories used to…

  6. National STD Awareness Month and GYT: Get Yourself Tested PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-03-03

    April is National STD Awareness Month. In this PSA, native communities, especially adolescents and young adults, are encouraged to get educated, tested, and treated by visiting gytnow.org.  Created: 3/3/2011 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.   Date Released: 3/3/2011.

  7. PSA Velocity Does Not Improve Prostate Cancer Detection | Division of Cancer Prevention

    Science.gov (United States)

    A rapid increase in prostate-specific antigen (PSA) levels is not grounds for automatically recommending a prostate biopsy, according to a study published online February 24 in the Journal of the National Cancer Institute. |

  8. Unpackaged Cigarettes and Smokeless Tobacco: What Retailers Need to Know PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-10-28

    This PSA helps retailers understand new federal regulations surrounding the sale of unpackaged cigarettes and smokeless tobacco.  Created: 10/28/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 10/28/2010.

  9. Don't Sell Tobacco to Minors: What Retailers Need to Know PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-07-08

    PSA helps raise retailers awareness of the new federal tobacco regulations related to sale of cigarettes and smokeless tobacco products to people under 18.  Created: 7/8/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 7/8/2010.

  10. Put Out the Myth: There Is No Such Thing as a Safe Cigarette PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-07-21

    PSA helps raise retailers' and manufacturers' awareness of the new federal tobacco regulations related to the production and sale of cigarettes labeled as "light," "low," or "mild.".  Created: 7/21/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 7/21/2010.

  11. CDC: Tips from Former Smokers – Cessation PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2012-04-04

    You can quit smoking! This inspiring 30 second PSA features three people who successfully quit smoking after many years. They share their practical tips on how to quit for good.  Created: 4/4/2012 by Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 4/4/2012.

  12. The Obesity Epidemic – What Can Be Done? PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-08-03

    This 60 second PSA is based on the August 2010 CDC Vital Signs report which provides information on obesity and what you can do to help fight the epidemic.  Created: 8/3/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 8/3/2010.

  13. Time from first detectable PSA following radical prostatectomy to biochemical recurrence: A competing risk analysis

    NARCIS (Netherlands)

    L. De Boo (Leonora); M. Pintilie (Melania); P. Yip (Paul); J. Baniel (Jack); N.E. Fleshner (Neil); D. Margel (David)

    2015-01-01

    textabstractIntroduction: In this study, we estimated the time from first detectable prostate-specific antigen (PSA) following radical prostatectomy (RP) to commonly used definitions of biochemical recurrence (BCR). We also identified the predictors of time to BCR. Methods: We identified subjects

  14. Patients with Central Lines - What You Need to Know to Avoid a Bloodstream Infection PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-03-01

    This 60 second PSA is based on the March, 2011 CDC Vital Signs report which indicates bloodstream infections in patients with central lines are largely preventable when healthcare providers use CDC-recommended infection control steps.  Created: 3/1/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 3/1/2011.

  15. Graphic Health Warnings for Cigarettes: What You Need to Know PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-11-18

    PSA about new graphic health warnings for cigarette packages and advertisements.  Created: 11/18/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 11/18/2010.

  16. New Hope for Stopping HIV - Testing and Medical Care Save Lives PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-11-29

    This 60 second PSA is based on the December 2011 CDC Vital Signs report, "HIV Prevention through Care and Treatment" that shares new hope for preventing HIV and improving the health of people with HIV.  Created: 11/29/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 11/29/2011.

  17. Utility of Prostate Specific Antigen (PSA) in the Indigenous African Man

    African Journals Online (AJOL)

    Objectives: To examine the great possibility that the indigenous black African man with prostate diseases requires a different diagnostic approach and strategies beyond the standard PSA reference levels generated in non-African study subjects. Design: A hospital based cross-sectional descriptive study. Setting: The ...

  18. Evaluating engrailed-2 and cytokines in urine with serum PSA as ...

    African Journals Online (AJOL)

    Evaluating engrailed-2 and cytokines in urine with serum PSA as potential biomarkers in patients with prostatism at Moi Teaching and Referral Hospital, Eldoret, Kenya. ... Conclusion: EN-2 expression in urine was not a predictive marker, however, IL-6 and TNF-α levels were elevated in urine of CaP patients. The potential ...

  19. Total Order Reliability in PSA: Importance of Basic Events and Systems

    Energy Technology Data Exchange (ETDEWEB)

    E. Borgonovo; C. Smith

    2010-06-01

    The purpose of this work is twofold. First, to formalize the properties of the total order reliability importance measure for PSA models. Second, to extend the definition of the total order importance measure to groups of basic events. This allows one to obtain the importance of systems and to address the relevance of interactions among systems.

  20. Development and validation of a prediction model for adenoma detection during screening and surveillance colonoscopy with comparison to actual adenoma detection rates.

    Directory of Open Access Journals (Sweden)

    Eelco C Brand

    Full Text Available The adenoma detection rate (ADR varies widely between physicians, possibly due to patient population differences, hampering direct ADR comparison. We developed and validated a prediction model for adenoma detection in an effort to determine if physicians' ADRs should be adjusted for patient-related factors.Screening and surveillance colonoscopy data from the cross-sectional multicenter cluster-randomized Endoscopic Quality Improvement Program-3 (EQUIP-3 study (NCT02325635 was used. The dataset was split into two cohorts based on center. A prediction model for detection of ≥1 adenoma was developed using multivariable logistic regression and subsequently internally (bootstrap resampling and geographically validated. We compared predicted to observed ADRs.The derivation (5 centers, 35 physicians, overall-ADR: 36% and validation (4 centers, 31 physicians, overall-ADR: 40% cohort included respectively 9934 and 10034 patients (both cohorts: 48% male, median age 60 years. Independent predictors for detection of ≥1 adenoma were: age (optimism-corrected odds ratio (OR: 1.02; 95%-confidence interval (CI: 1.02-1.03, male sex (OR: 1.73; 95%-CI: 1.60-1.88, body mass index (OR: 1.02; 95%-CI: 1.01-1.03, American Society of Anesthesiology physical status class (OR class II vs. I: 1.29; 95%-CI: 1.17-1.43, OR class ≥III vs. I: 1.57; 95%-CI: 1.32-1.86, surveillance versus screening (OR: 1.39; 95%-CI: 1.27-1.53, and Hispanic or Latino ethnicity (OR: 1.13; 95%-CI: 1.00-1.27. The model's discriminative ability was modest (C-statistic in the derivation: 0.63 and validation cohort: 0.60. The observed ADR was considerably lower than predicted for 12/66 (18.2% physicians and 2/9 (22.2% centers, and considerably higher than predicted for 18/66 (27.3% physicians and 4/9 (44.4% centers.The substantial variation in ADRs could only partially be explained by patient-related factors. These data suggest that ADR variation could likely also be due to other factors, e

  1. A community-based screening campaign for the detection of diabetes mellitus and hypertension in the eastern province, Saudi Arabia: Methods and participation rates

    Directory of Open Access Journals (Sweden)

    Ageel J Al-Ghamdi

    2007-01-01

    Conclusion: Community screening campaigns for diabetes mellitus and hypertension is extremely efficient in identifying undiagnosed diabetic and hypertensive individuals. The most successful strategy for the screening and confirmation of results was through PHCCs, especially in the rural areas, where there was good organization and strict adherence to guidelines on methodology.

  2. Targeted prostate cancer screening in BRCA1 and BRCA2 mutation carriers: results from the initial screening round of the IMPACT study.

    Science.gov (United States)

    Bancroft, Elizabeth K; Page, Elizabeth C; Castro, Elena; Lilja, Hans; Vickers, Andrew; Sjoberg, Daniel; Assel, Melissa; Foster, Christopher S; Mitchell, Gillian; Drew, Kate; Mæhle, Lovise; Axcrona, Karol; Evans, D Gareth; Bulman, Barbara; Eccles, Diana; McBride, Donna; van Asperen, Christi; Vasen, Hans; Kiemeney, Lambertus A; Ringelberg, Janneke; Cybulski, Cezary; Wokolorczyk, Dominika; Selkirk, Christina; Hulick, Peter J; Bojesen, Anders; Skytte, Anne-Bine; Lam, Jimmy; Taylor, Louise; Oldenburg, Rogier; Cremers, Ruben; Verhaegh, Gerald; van Zelst-Stams, Wendy A; Oosterwijk, Jan C; Blanco, Ignacio; Salinas, Monica; Cook, Jackie; Rosario, Derek J; Buys, Saundra; Conner, Tom; Ausems, Margreet G; Ong, Kai-ren; Hoffman, Jonathan; Domchek, Susan; Powers, Jacquelyn; Teixeira, Manuel R; Maia, Sofia; Foulkes, William D; Taherian, Nassim; Ruijs, Marielle; Helderman-van den Enden, Apollonia T; Izatt, Louise; Davidson, Rosemarie; Adank, Muriel A; Walker, Lisa; Schmutzler, Rita; Tucker, Kathy; Kirk, Judy; Hodgson, Shirley; Harris, Marion; Douglas, Fiona; Lindeman, Geoffrey J; Zgajnar, Janez; Tischkowitz, Marc; Clowes, Virginia E; Susman, Rachel; Ramón y Cajal, Teresa; Patcher, Nicholas; Gadea, Neus; Spigelman, Allan; van Os, Theo; Liljegren, Annelie; Side, Lucy; Brewer, Carole; Brady, Angela F; Donaldson, Alan; Stefansdottir, Vigdis; Friedman, Eitan; Chen-Shtoyerman, Rakefet; Amor, David J; Copakova, Lucia; Barwell, Julian; Giri, Veda N; Murthy, Vedang; Nicolai, Nicola; Teo, Soo-Hwang; Greenhalgh, Lynn; Strom, Sara; Henderson, Alex; McGrath, John; Gallagher, David; Aaronson, Neil; Ardern-Jones, Audrey; Bangma, Chris; Dearnaley, David; Costello, Philandra; Eyfjord, Jorunn; Rothwell, Jeanette; Falconer, Alison; Gronberg, Henrik; Hamdy, Freddie C; Johannsson, Oskar; Khoo, Vincent; Kote-Jarai, Zsofia; Lubinski, Jan; Axcrona, Ulrika; Melia, Jane; McKinley, Joanne; Mitra, Anita V; Moynihan, Clare; Rennert, Gad; Suri, Mohnish; Wilson, Penny; Killick, Emma; Moss, Sue; Eeles, Rosalind A

    2014-09-01

    Men with germline breast cancer 1, early onset (BRCA1) or breast cancer 2, early onset (BRCA2) gene mutations have a higher risk of developing prostate cancer (PCa) than noncarriers. IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls) is an international consortium of 62 centres in 20 countries evaluating the use of targeted PCa screening in men with BRCA1/2 mutations. To report the first year's screening results for all men at enrollment in the study. We recruited men aged 40-69 yr with germline BRCA1/2 mutations and a control group of men who have tested negative for a pathogenic BRCA1 or BRCA2 mutation known to be present in their families. All men underwent prostate-specific antigen (PSA) testing at enrollment, and those men with PSA >3 ng/ml were offered prostate biopsy. PSA levels, PCa incidence, and tumour characteristics were evaluated. The Fisher exact test was used to compare the number of PCa cases among groups and the differences among disease types. We recruited 2481 men (791 BRCA1 carriers, 531 BRCA1 controls; 731 BRCA2 carriers, 428 BRCA2 controls). A total of 199 men (8%) presented with PSA >3.0 ng/ml, 162 biopsies were performed, and 59 PCas were diagnosed (18 BRCA1 carriers, 10 BRCA1 controls; 24 BRCA2 carriers, 7 BRCA2 controls); 66% of the tumours were classified as intermediate- or high-risk disease. The positive predictive value (PPV) for biopsy using a PSA threshold of 3.0 ng/ml in BRCA2 mutation carriers was 48%-double the PPV reported in population screening studies. A significant difference in detecting intermediate- or high-risk disease was observed in BRCA2 carriers. Ninety-five percent of the men were white, thus the results cannot be generalised to all ethnic groups. The IMPACT screening network will be useful for targeted PCa screening studies in men with germline genetic risk variants as they are discovered. These preliminary results support the

  3. The Case for Tailored Prostate Cancer Screening: An NCCN Perspective.

    Science.gov (United States)

    McDonald, Michelle L; Parsons, J Kellogg

    2015-12-01

    A preponderance of clinical evidence supports a significant public health benefit for screening and early detection of prostate cancer in selected men. The challenge lies in maximizing early diagnosis of potentially aggressive but curable disease while minimizing diagnosis and treatment of indolent disease. A tailored approach to population screening in appropriately counseled men, using an evidence-based strategy with judicious prostate-specific antigen (PSA) testing, will reduce prostate-cancer mortality yet limit overdetection of clinically insignificant disease. Use of newer biomarkers that increase specificity for prostate cancer detection, including percentage of free PSA, 4Kscore, prostate health index, prostate cancer antigen 3, and multiparametric MRI may be considered under certain circumstances. Copyright © 2015 by the National Comprehensive Cancer Network.

  4. Porous silicon antibody microarrays for quantitative analysis: measurement of free and total PSA in clinical plasma samples.

    Science.gov (United States)

    Järås, Kerstin; Adler, Belinda; Tojo, Axel; Malm, Johan; Marko-Varga, György; Lilja, Hans; Laurell, Thomas

    2012-12-24

    The antibody microarrays have become widespread, but their use for quantitative analyses in clinical samples has not yet been established. We investigated an immunoassay based on nanoporous silicon antibody microarrays for quantification of total prostate-specific-antigen (PSA) in 80 clinical plasma samples, and provide quantitative data from a duplex microarray assay that simultaneously quantifies free and total PSA in plasma. To further develop the assay the porous silicon chips was placed into a standard 96-well microtiter plate for higher throughput analysis. The samples analyzed by this quantitative microarray were 80 plasma samples obtained from men undergoing clinical PSA testing (dynamic range: 0.14-44 ng/ml, LOD: 0.14 ng/ml). The second dataset, measuring free PSA (dynamic range: 0.40-74.9 ng/ml, LOD: 0.47 ng/ml) and total PSA (dynamic range: 0.87-295 ng/ml, LOD: 0.76 ng/ml), was also obtained from the clinical routine. The reference for the quantification was a commercially available assay, the ProStatus PSA Free/Total DELFIA. In an analysis of 80 plasma samples the microarray platform performs well across the range of total PSA levels. This assay might have the potential to substitute for the large-scale microtiter plate format in diagnostic applications. The duplex assay paves the way for a future quantitative multiplex assay, which analyzes several prostate cancer biomarkers simultaneously. Copyright © 2012 Elsevier B.V. All rights reserved.

  5. Effects of cyclic adenosine-monophosphate on growth and PSA secretion of human prostate cancer cell line.

    Science.gov (United States)

    Macchia, V; Di Carlo, A; De Luca, C; Mariano, A

    2001-05-01

    Prolonged increase of cyclic adenosine-monophosphate (cAMP) level in the culture medium of a well differentiated human prostatic cancer cell (LNCaP) inhibits cellular growth and stimulates PSA secretion. The differentiation of the cells tested was documented by their responsiveness to androgens and the ability to synthesize cellular markers of differentiation (PSA). The raise in cAMP level was produced by dibutyryl cyclic AMP (DBcAMP) or by agents acting at distinct levels in the pathway of cAMP generation (forskolin) or degradation (IBMX). Each of these three agents in a range of concentrations between 10-4-10-6 M had an inhibitory effect on the growth which is dose and time-dependent. The inhibition was reversible as demonstrated by complete restoration of cell growth soon after the withdrawal of the substances from the culture medium. When cAMP levels in culture medium was raised, an increase in PSA content was observed. However, the effects of cAMP on PSA content was not due to increase in PSA synthesis, since simultaneous measurement of secreted and cellular PSA indicated that the principal effect of the cyclic nucleotide was to enhance the secretion of stored PSA. Furthermore the inhibition of cellular growth by cAMP suggests new approaches in prostatic carcinoma therapy.

  6. Prostate Cancer Screening : The effect on prostate cancer mortality and incidence

    NARCIS (Netherlands)

    P.J. van Leeuwen (Pim)

    2012-01-01

    textabstractAt first glance, deciding whether to get the PSA screening test for prostate cancer seems to be pretty straightforward and attractive. It’s a simple blood test that can pick up the prostate cancer long before your symptoms appear. After all, your prostate cancer is earlier treated

  7. Lead Time and Overdiagnosis in Prostate-Specific Antigen Screening : Importance of Methods and Context

    NARCIS (Netherlands)

    Draisma, Gerrit; Etzioni, Ruth; Tsodikov, Alex; Mariotto, Angela; Wever, Elisabeth; Gulati, Roman; Feuer, Eric; de Koning, Harry

    2009-01-01

    Background The time by which prostate-specific antigen (PSA) screening advances prostate cancer diagnosis, called the lead time, has been reported by several studies, but results have varied widely, with mean lead times ranging from 3 to 12 years. A quantity that is closely linked with the lead time

  8. Lead time and overdiagnosis in prostate-specific antigen screening: Importance of methods and context

    NARCIS (Netherlands)

    G. Draisma (Gerrit); R. Etzioni (Ruth); A. Tsodikov (Alex); A. Mariotto (Angela); E.M. Wever (Elisabeth); R. Gulati (Roman); E. Feuer (Eric); H.J. de Koning (Harry)

    2009-01-01

    textabstractBackground The time by which prostate-specific antigen (PSA) screening advances prostate cancer diagnosis, called the lead time, has been reported by several studies, but results have varied widely, with mean lead times ranging from 3 to 12 years. A quantity that is closely linked with

  9. Exposure reduces negative bias in self-rated performance in public speaking fearful participants.

    Science.gov (United States)

    Cheng, Joyce; Niles, Andrea N; Craske, Michelle G

    2017-03-01

    Individuals with public speaking anxiety (PSA) under-rate their performance compared to objective observers. The present study examined whether exposure reduces the discrepancy between self and observer performance ratings and improved observer-rated performance in individuals with PSA. PSA participants gave a speech in front of a small audience and rated their performance using a questionnaire before and after completing repeated exposures to public speaking. Non-anxious control participants gave a speech and completed the questionnaire one time only. Objective observers watched videos of the speeches and rated performance using the same questionnaire. PSA participants underrated their performance to a greater degree than did controls prior to exposure, but also performed significantly more poorly than did controls when rated objectively. Bias significantly decreased and objective-rated performance significantly increased following completion of exposure in PSA participants, and on one performance measure, anxious participants no longer showed a greater discrepancy between self and observer performance ratings compared to controls. The study employed non-clinical student sample, but the results should be replicated in clinical anxiety samples. These findings indicate that exposure alone significantly reduces negative performance bias among PSA individuals, but additional exposure or additional interventions may be necessary to fully correct bias and performance deficits. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Screening for prostate cancer: the current evidence and guidelines controversy.

    Science.gov (United States)

    Gomella, Leonard G; Liu, Xiaolong S; Trabulsi, Edouard J; Kelly, Wm Kevin; Myers, Ronald; Showalter, Timothy; Dicker, Adam; Wender, Richard

    2011-10-01

    Prostate cancer presents a global public health dilemma. While screening with prostate specific antigen (PSA) has led to more men diagnosed with prostate cancer than in previous years, the potential for negative effects from over-diagnosis and treatment cannot be ignored. We reviewed Medline for recent articles that discuss clinical trials, evidence based recommendations and guidelines from major medical organizations in the United States and worldwide concerning prostate cancer screening. Results from the European Randomized Screening for Prostate Cancer (ERSPC), the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, and Göteborg Swedish trials regarding prostate screening are controversial with the ERSPC and Göteborg showing a reduction in prostate cancer mortality and the PLCO trial showing no benefit. Recommendations from the American Urological Association (AUA), Japanese Urological Association (JUA), and National Comprehensive Cancer Network (NCCN) have recommended that all men obtain a baseline PSA beginning at age 40. The American Cancer Society (ACS) stratifies screening recommendations based on age and risk, but states that screening should take place only after an informed discussion between provider and patient. The United States Preventative Health Service Task Force (USPSTF) states that evidence is insufficient to assess the risks and benefits of prostate cancer screening in men younger than 75 years. Other major international health organizations offer a similar reserved approach or recommend against screening for prostate cancer. Most groups indicate that screening to determine who should undergo prostate biopsy typically includes both a serum PSA and digital rectal examination, with the latest ACS publications noting that the rectal exam is optional. A common theme from all groups is that an informed discussion with the patients is strongly recommended and that screening does increase the number of men diagnosed with non

  11. Prostate-Specific Antigen Bounce After High-Dose-Rate Monotherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mehta, Niraj H., E-mail: nmehta@mednet.ucla.edu [University of California, Los Angeles, Los Angeles, California (United States); Kamrava, Mitchell; Wang, Pin-Chieh; Steinberg, Michael; Demanes, Jeffrey [University of California, Los Angeles, Los Angeles, California (United States)

    2013-07-15

    Purpose: To characterize the magnitude and kinetics of prostate-specific antigen (PSA) bounces after high-dose-rate (HDR) monotherapy and determine relationships between certain clinical factors and PSA bounce. Methods and Materials: Longitudinal PSA data and various clinical parameters were examined in 157 consecutive patients treated with HDR monotherapy between 1996 and 2005. We used the following definition for PSA bounce: rise in PSA ≥threshold, after which it returns to the prior level or lower. Prostate-specific antigen failure was defined per the Phoenix definition (nadir +2 ng/mL). Results: A PSA bounce was noted in 67 patients (43%). The number of bounces per patient was 1 in 45 cases (67%), 2 in 19 (28%), 3 in 2 (3%), 4 in 0, and 5 in 1 (1%). The median time to maximum PSA bounce was 1.3 years, its median magnitude was 0.7, and its median duration was 0.75 years. Three patients (2%) were noted to have PSA failure. None of the 3 patients who experienced biochemical failure exhibited PSA bounce. In the fully adjusted model for predicting each bounce, patients aged <55 years had a statistically significant higher likelihood of experiencing a bounce (odds ratio 2.22, 95% confidence interval 1.38-3.57, P=.001). There was also a statistically significant higher probability of experiencing a bounce for every unit decrease in Gleason score (odds ratio 1.52, 95% confidence interval 1.01-2.04, P=.045). Conclusions: A PSA bounce occurs in a significant percentage of patients treated with HDR monotherapy, with magnitudes varying from <1 in 28% of cases to ≥1 in 15%. The median duration of bounce is <1 year. More bounces were identified in patients with lower Gleason score and age <55 years. Further investigation using a model to correlate magnitude and frequency of bounces with clinical variables are under way.

  12. Trends in prostate cancer incidence and mortality in Canada during the era of prostate-specific antigen screening.

    Science.gov (United States)

    Dickinson, James; Shane, Amanda; Tonelli, Marcello; Connor Gorber, Sarah; Joffres, Michel; Singh, Harminder; Bell, Neil

    2016-01-01

    Widespread use of prostate-specific antigen (PSA) to screen for prostate cancer began in the early 1990s. Advocates for screening assert that this has caused a decrease in prostate cancer mortality. We sought to describe secular changes in prostate cancer incidence and mortality in Canada in relation to the onset of PSA screening. Age-standardized and age-specific prostate cancer incidence (1969-2007) and mortality (1969-2009) from Public Health Agency of Canada databases were analyzed by joinpoint regression. Changes in incidence and mortality were related to introduction of PSA screening. Prior to PSA screening, prostate cancer incidence increased from 54.2 to 99.8 per 100 000 between 1969 and 1990. Thereafter, incidence increased sharply (12.8% per year) to peak at 140.8/100 000 in 1993. After decreasing in all age groups between 1993 and 1996, incidence continued to increase for men aged less than 70 years, but decreased for older men. Age-standardized mortality was stable from 1969 to 1977, increased 1.4% per year to peak in 1995 and subsequently decreased at 3.3% per year; the decline started from 1987 in younger men (age prostate cancer mortality began before PSA screening was widely used and were larger than could be anticipated from screening alone. These findings suggest that screening caused artifactual increase in incidence, but no more than a part of reductions in prostate cancer mortality. The reduction may be due to changing treatment or certification of death.

  13. Variation of Prostate-specific Antigen Value in Men and Risk of High-grade Prostate Cancer: Analysis of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Study.

    Science.gov (United States)

    Boniol, Mathieu; Autier, Philippe; Perrin, Paul; Boyle, Peter

    2015-05-01

    To investigate variations in prostate-specific antigen (PSA) levels among men with an initial normal PSA level in the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial study. Data were extracted from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial study data set on all men in the interventional arm, with 2 tests performed in a period of levels was 3.4% (interquartile range, -15% to +26%). The variation in PSA value was not associated with the delay between the first and the second test (P = .36), age (P = .16), body mass index (P = .41), and race (P = .12). A total of 2,781 prostate cancers were diagnosed during follow-up. Adjusting for age and initial PSA level, the risk of prostate cancer increased linearly with increasing PSA level at the second test, with an odds ratio of 1.079 (95% confidence interval, 1.058-1.101) for each percent increase in PSA level. However, the variation in PSA was not associated with a higher Gleason score (P = .95 for level variations in cancer of Gleason score level over time is associated with increased risk of prostate cancer, this association is not related to more aggressive tumors. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Higher rates and clustering of abnormal lipids, obesity, and diabetes mellitus in psoriatic arthritis compared with rheumatoid arthritis.

    Science.gov (United States)

    Labitigan, Monalyn; Bahče-Altuntas, Asena; Kremer, Joel M; Reed, George; Greenberg, Jeff D; Jordan, Nicole; Putterman, Chaim; Broder, Anna

    2014-04-01

    We compared the prevalence and the clustering of the metabolic syndrome (MetS) components (obese body mass index [BMI; ≥30 kg/m(2) ], hypertriglyceridemia, low high-density lipids, hypertension, and diabetes mellitus) in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) in the Consortium of Rheumatology Researchers of North America (CORRONA) Registry. We included CORRONA participants with a rheumatologist-confirmed clinical diagnosis of PsA or RA with complete data. We used a modified definition of MetS that did not include insulin resistance, waist circumference, or blood pressure measurements. Logistic regression models were adjusted for age, sex, and race. In the overall CORRONA population, the rates of diabetes mellitus and obesity were significantly higher in PsA compared with RA. In 294 PsA and 1,162 RA participants who had lipids measured, the overall prevalence of MetS in PsA versus RA was 27% versus 19%. The odds ratio (OR) of MetS in PsA versus RA was 1.44 (95% confidence interval [95% CI] 1.05-1.96, P = 0.02). The prevalence of hypertriglyceridemia was higher in PsA compared with RA (38% versus 28%; OR 1.51 [95% CI 1.15-1.98], P = 0.003). The prevalence of type 2 diabetes mellitus was also higher in PsA compared with RA (15% versus 11%; OR 1.56 [95% CI 1.07-2.28], P = 0.02) in the adjusted model. Similarly, higher rates of hypertriglyceridemia and diabetes mellitus were observed in the subgroup of PsA and RA patients with obese BMI. Compared with RA, PsA is associated with higher rates of obesity, diabetes mellitus, and hypertriglyceridemia. Copyright © 2014 by the American College of Rheumatology.

  15. Higher Rates and Clustering of Abnormal Lipids, Obesity, and Diabetes in Psoriatic Arthritis Compared with Rheumatoid Arthritis

    Science.gov (United States)

    Labitigan, Monalyn; Bahce-Altuntas, Asena; Kremer, Joel M; Reed, George; Greenberg, Jeff D; Jordan, Nicole; Putterman, Chaim; Broder, Anna

    2014-01-01

    Objective We compared the prevalence and the clustering of the Metabolic Syndrome (MetS) components: obese body mass index (BMI ≥ 30 kg/m2), hypertriglyceridemia, low high-density lipids, hypertension and diabetes, in patients with psoriatic arthritis (PsA) and rheumatoid arthritis (RA) in the Consortium of Rheumatology Researchers of North America (CORRONA) registry. Methods We included CORRONA participants with the rheumatologist-confirmed clinical diagnoses of PsA and RA with complete data. We used a modified definition of MetS that did not include insulin resistance, waist circumference or blood pressure measurements. Logistic regression models were adjusted for age, sex and race. Results In the overall CORRONA population, the rates of diabetes and obesity were significantly higher in PsA compared with RA. In 294 PsA and 1162 RA participants who had lipids measured, the overall prevalence of MetS in PsA vs. RA was 27% vs. 19%. The odds ratio (OR) of MetS in PsA vs. RA was 1.44 (95% confidence interval (CI) 1.05 to 1.96), p=0.02. The prevalence of hypertriglyceridemia was higher in PsA compared with RA, 38% vs. 28%, OR 1.51 (95% CI 1.15 to 1.98), p=0.003. The prevalence of type II diabetes was also higher in PsA compared with RA (15% vs. 11%), OR 1.56 (95% CI 1.07 to 2.28), p=0.02, in the adjusted model. Similarly, higher rates of hypertriglyceridemia and diabetes were observed in the subgroup of PsA and RA patients with obese BMI. Conclusion PsA is associated with the higher rates of obesity, diabetes, and hypertriglyceridemia, compared with RA. PMID:24115739

  16. First-trimester screening for trisomy 21 in Denmark: implications for detection and birth rates of trisomy 18 and trisomy 13

    DEFF Research Database (Denmark)

    Ekelund, C K; Petersen, Ole; Skibsted, Leif Horsfelt

    2011-01-01

    In Denmark a new national guideline for prenatal screening and diagnosis was issued in 2004 according to which all pregnant women should be offered a first-trimester combined risk assessment for trisomy 21 (T21). The aim of this study was to investigate whether the new screening strategy for T21...... has changed the gestational age at which trisomy 18 (T18) and trisomy 13 (T13) are diagnosed prenatally, and the number of infants born with T18 or T13....

  17. Dissemination of Prostate Cancer Screening to PCP’s in African American Communities

    Science.gov (United States)

    2005-04-01

    associate the rectal examination in particular with sexual behavior. The DRE seemed to undermine heterosexual notions of manhood, and to tap an...undercurrent of " homophobia ." The PSA, as a blood test not involving rectal insertions, was not similarly "undignified." As one man expressed: "Yes, I think it’s...prostate cancer screening with the DRE] all about... maybe for some men it’s a homophobia . I think that’s the issue here. But I think with the PSA

  18. Take Charge. Take the Test. "Look Out For Yourself" PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-03-07

    As part of the Take Charge. Take the Test. campaign, this 60 second PSA encourages African American women to get tested for HIV. Locations for a free HIV test can be found by visiting hivtest.org/takecharge or calling 1-800-CDC-INFO (1-800-232-4636).  Created: 3/7/2012 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 3/7/2012.

  19. We Can Stop HIV One Conversation at a Time Radio PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2014-08-27

    As part of the We Can Stop HIV One Conversation at a Time campaign, this 30 second PSA encourages Hispanics/Latinos to talk openly about HIV and AIDS with their families, friends, partners, and communities.  Created: 8/27/2014 by National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP).   Date Released: 8/27/2014.

  20. Binge Drinking – Nationwide Problem, Local Solutions PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2012-01-03

    This 60 second PSA is based on the January 2012 CDC Vital Signs report. One in six adults binge drinks about four times a month. It's a problem nationwide but community-based strategies, such as reducing access to alcohol and increasing the price, can prevent binge drinking.  Created: 1/3/2012 by Centers for Disease Control and Prevention (CDC).   Date Released: 1/3/2012.

  1. Face-to-face Tobacco Sales: What Retailers Need to Know PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2010-09-30

    PSA to help raise retailers' awareness of the new federal tobacco regulations related to the sale of cigarettes and smokeless tobacco products to people under 18 and the requirement to sell products face-to-face.  Created: 9/30/2010 by The CDC Division of News and Electronic Media and the FDA Center for Tobacco Products.   Date Released: 9/30/2010.

  2. Exploring Functional ?-Cell Heterogeneity In Vivo Using PSA-NCAM as a Specific Marker

    OpenAIRE

    Karaca, Melis; Castel, Julien; Tourrel-Cuzin, C?cile; Brun, Manuel; G?ant, Anne; Dubois, Mathilde; Catesson, Sandra; Rodriguez, Marianne; Luquet, Serge; Cattan, Pierre; Lockhart, Brian; Lang, Jochen; Ktorza, Alain; Magnan, Christophe; Kargar, Catherine

    2009-01-01

    BACKGROUND: The mass of pancreatic beta-cells varies according to increases in insulin demand. It is hypothesized that functionally heterogeneous beta-cell subpopulations take part in this process. Here we characterized two functionally distinct groups of beta-cells and investigated their physiological relevance in increased insulin demand conditions in rats. METHODS: Two rat beta-cell populations were sorted by FACS according to their PSA-NCAM surface expression, i.e. beta(high) and beta(low...

  3. Making Food Safer to Eat - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2011-06-07

    This 60 second Public Service Announcement (PSA) is based on the June, 2011 CDC Vital Signs report. One in six Americans gets sick from eating contaminated food each year. To reduce your risk, remember to clean, separate, cook, and chill.  Created: 6/7/2011 by Centers for Disease Control and Prevention (CDC).   Date Released: 6/7/2011.

  4. The Tobacco Use Epidemic - What You Need to Know PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2010-09-07

    This PSA is based on the September, 2010 CDC Vital Signs report which indicates that, despite the dangers of tobacco use, about 46.6 million adults in the U.S. smoke, and 88 million nonsmokers are exposed to secondhand smoke. .  Created: 9/7/2010 by Centers for Disease Control and Prevention (CDC).   Date Released: 9/7/2010.

  5. Use of PSA and severe accident assessment results for the accident management

    Energy Technology Data Exchange (ETDEWEB)

    Jang, S. H.; Kim, H. G.; Jang, H. S.; Moon, S. K.; Park, J. U. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    1993-12-15

    The objectives for this study are to investigate the basic principle or methodology which is applicable to accident management, by using the results of PSA and severe accident research, and also facilitate the preparation of accidents management program in the future. This study was performed as follows: derivation of measures for core damage prevention, derivation of measures for accident mitigation, application of computerized tool to assess severe accident management.

  6. Guidelines for reliability analysis of digital systems in PSA context - Phase 2 Status report

    Energy Technology Data Exchange (ETDEWEB)

    Authen, S. (Risk Pilot AB, Stockholm (Sweden)); Gustafsson, J. (Royal Institute of Technology (Sweden)); Holmberg, J.-E. (VTT Technical Research Centre of Finland (Finland))

    2012-02-15

    The OECD/NEA CSNI Working Group on Risk Assessment (WGRisk) has set up a task group called DIGREL to develop a taxonomy of failure modes of digital components for the purposes of probabilistic safety assessment (PSA). A parallel Nordic activity carried out a pre-study where a comparison of Nordic experiences and a literature review were performed. The study showed a wide range of approaches and solutions to the challenges given by digital I and C. In 2011, a proposal for the failure modes taxonomy was defined. This is based on a set of requirements agreed on the purpose of the taxonomy. The following levels of details can be distinguished from the hardware point of view: (1) the entire system, (2) a division, (3) processing units (and cabinets), (4) modules, i.e. subcomponents of processing units and (5) generic components, i.e. subcomponents of modules. Module level seems to be the most appropriate from the PSA modelling point of view. The software failure modes taxonomy is still an open issue. An existing simplified PSA model has been complemented with fault tree models for a four-redundant distributed protection system in order to study and demonstrate the effect of design features and modelling approaches. The example shows that even rather simple I and C design leads to rather complex model despite of the fact that many things have been simplified and only a few protection signals are considered. One lesson from the example is that the Alpha factor model should be used to model common cause failures instead of the Beta factor model. Two options were developed to the comparison of different fail-safe principles. The role of detectable and undetectable failure modes with respect to the failed versus spurious actuations can be clearly seen in the results, showing the importance to model these features in PSA. (Author)

  7. CDC: Tips from Former Smokers – Jessica PSA (:30)

    Centers for Disease Control (CDC) Podcasts

    2012-04-04

    Exposure to secondhand smoke can trigger a life-threatening asthma attack. This 30 second PSA features Jessica, a mother with a young son who suffers from asthma attacks triggered by secondhand smoke exposure.  Created: 4/4/2012 by Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion.   Date Released: 4/4/2012.

  8. Galectin-3 Is a Substrate for Prostate Specific Antigen (PSA) in Human Seminal Plasma

    Science.gov (United States)

    Saraswati, Sarika; Block, Ashley S.; Davidson, Mari. K.; Rank, Roger. G.; Mahadevan, Maha; Diekman, Alan B.

    2012-01-01

    Background Galectin-3 is a multivalent carbohydrate-binding protein involved in cell adhesion, cell cycle control, immunomodulation, and cancer progression, including prostate cancer. Galectin-3 function is regulated by proteolytic cleavage that destroys galectin-3 multivalency while preserving carbohydrate-binding activity. In human semen, galectin-3 is present in seminal plasma and is also associated with prostasomes, exosome-like vesicles secreted by the prostate. In the current study, we characterized the proteolytic activity that cleaves galectin-3 in human seminal plasma. Methods An in vitro assay was developed to investigate galectin-3 cleavage in seminal plasma. The effect of protease inhibitors, divalent ion chelators, and Zn2+ on the cleavage activity was determined. Proteases enriched from seminal plasma were tested for their ability to cleave galectin-3. Affinity purification and microsequence analysis were used to identify the cleavage site in galectin-3. Results Galectin-3 was identified in human seminal plasma in an intact and truncated form. Gelatinases enriched from seminal plasma did not cleave galectin-3. Inhibitor studies indicated that the galectin-3 cleavage activity in seminal plasma is a Zn2+ sensitive, serine protease. Prostate specific antigen (PSA) was demonstrated to cleave galectin-3 between tyrosine107-glycine108 and produce a functionally-active, monovalent lectin. Conclusions PSA is a chymotrypsin-like serine protease secreted by the prostatic epithelium and normally functions in liquefaction of semen following ejaculation. Furthermore, PSA is implicated in the promotion of localized prostate tumors and bone metastases by its roles in immunomodulation, invasion, and apoptosis. Our results indicate that PSA regulates galectin-3 in human semen and may regulate galectin-3 function during prostate cancer progression. PMID:20672323

  9. Lycopene Supplementation in the Complementary Management of PSA Failure: A Randomized Placebo-Controlled Trial for Prostate Cancer Survivors

    National Research Council Canada - National Science Library

    Ukoli, Flora A; Kucuk, Omer; Fowke, Jay H

    2007-01-01

    ...) or whole-food supplement (Lyc-O-Mato(Registered)) in control of biochemical (PSA) failure in 78 African-American prostate cancer survivors treated initially by radical prostatectomy or radiation...

  10. Einschätzung des PSA-Rezidivs nach kurativer Therapie des Prostatakarzinoms

    Directory of Open Access Journals (Sweden)

    Weißbach L

    2004-01-01

    Full Text Available Das in die Nachsorge kurativ behandelter Patienten mit Prostatakarzinom aufgenommene PSA-Monitoring schafft einen neuen klinischen Status. Wir haben es jetzt mit einem "bio-chemisch Kranken" zu tun, bei dem nicht selten kein lokales Rezidivgeschehen und schon gar nicht eine Fernmetastasierung nachgewiesen werden kann. Um zwischen der lokalen und systemischen Erkrankung unterscheiden zu können, hat man sich früher der "pathohistologischen Prädiktion" bedient. Hierauf beruht auch ein großer Teil der häufig eingesetzten Nomogramme. Mit der Bestimmung der PSA-DT ist eine Methode in das diagnostische Repertoire aufgenommen worden, die nach weiterer Evaluierung dazu dienen könnte, lokale Maßnahmen (RT nach RP oder Salvage-Prostatektomie, HIFU bzw. Kryotherapie oder eine Androgendeprivation vorzunehmen. Vieles deutet darauf hin, daß wir in Zukunft nicht nur mit einer Berechnung der PSA-DT die lokale von der systemischen Progression unterscheiden können, sondern auch das Übergangsstadium zur klinischen Metastasenerkrankung voraussagen und das Risiko, am Prostatakrebs zu sterben, einschätzen können.

  11. Multiple external hazards compound level 3 PSA methods research of nuclear power plant

    Science.gov (United States)

    Wang, Handing; Liang, Xiaoyu; Zhang, Xiaoming; Yang, Jianfeng; Liu, Weidong; Lei, Dina

    2017-01-01

    2011 Fukushima nuclear power plant severe accident was caused by both earthquake and tsunami, which results in large amount of radioactive nuclides release. That accident has caused the radioactive contamination on the surrounding environment. Although this accident probability is extremely small, once such an accident happens that is likely to release a lot of radioactive materials into the environment, and cause radiation contamination. Therefore, studying accidents consequences is important and essential to improve nuclear power plant design and management. Level 3 PSA methods of nuclear power plant can be used to analyze radiological consequences, and quantify risk to the public health effects around nuclear power plants. Based on multiple external hazards compound level 3 PSA methods studies of nuclear power plant, and the description of the multiple external hazards compound level 3 PSA technology roadmap and important technical elements, as well as taking a coastal nuclear power plant as the reference site, we analyzed the impact of off-site consequences of nuclear power plant severe accidents caused by multiple external hazards. At last we discussed the impact of off-site consequences probabilistic risk studies and its applications under multiple external hazards compound conditions, and explained feasibility and reasonableness of emergency plans implementation.

  12. Hybrid approach for the assessment of PSA models by means of binary decision diagrams

    Energy Technology Data Exchange (ETDEWEB)

    Ibanez-Llano, Cristina, E-mail: cristina.ibanez@iit.upcomillas.e [Instituto de Investigacion Tecnologica (IIT), Escuela Tecnica Superior de Ingenieria ICAI, Universidad Pontificia Comillas, C/Santa Cruz de Marcenado 26, 28015 Madrid (Spain); Rauzy, Antoine, E-mail: Antoine.RAUZY@3ds.co [Dassault Systemes, 10 rue Marcel Dassault CS 40501, 78946 Velizy Villacoublay Cedex (France); Melendez, Enrique, E-mail: ema@csn.e [Consejo de Seguridad Nuclear (CSN), C/Justo Dorado 11, 28040 Madrid (Spain); Nieto, Francisco, E-mail: nieto@iit.upcomillas.e [Instituto de Investigacion Tecnologica (IIT), Escuela Tecnica Superior de Ingenieria ICAI, Universidad Pontificia Comillas, C/Santa Cruz de Marcenado 26, 28015 Madrid (Spain)

    2010-10-15

    Binary decision diagrams are a well-known alternative to the minimal cutsets approach to assess the reliability Boolean models. They have been applied successfully to improve the fault trees models assessment. However, its application to solve large models, and in particular the event trees coming from the PSA studies of the nuclear industry, remains to date out of reach of an exact evaluation. For many real PSA models it may be not possible to compute the BDD within reasonable amount of time and memory without considering the truncation or simplification of the model. This paper presents a new approach to estimate the exact probabilistic quantification results (probability/frequency) based on combining the calculation of the MCS and the truncation limits, with the BDD approach, in order to have a better control on the reduction of the model and to properly account for the success branches. The added value of this methodology is that it is possible to ensure a real confidence interval of the exact value and therefore an explicit knowledge of the error bound. Moreover, it can be used to measure the acceptability of the results obtained with traditional techniques. The new method was applied to a real life PSA study and the results obtained confirm the applicability of the methodology and open a new viewpoint for further developments.

  13. Penile Metastases of Recurrent Prostatic Adenocarcinoma without PSA Level Increase: A Case Report

    Directory of Open Access Journals (Sweden)

    Antonio Pierro

    2012-01-01

    Full Text Available We report a case of penile metastases from recurrent prostatic adenocarcinoma that was the first sign of a widespread metastatic disease in the absence of any increase in prostate-specific antigen (PSA level. In April 2011, an 80-year-old man presented to our Radiotherapy Unit with multiple palpable hard nodules in the penis, dysuria, and moderate perineal pain, 7 years after he had received radiotherapy for prostate cancer. Nodules in the penis had appeared in February 2011. The ultrasound and magnetic resonance (MR imaging suggested the diagnosis of multiple penile metastases. A total body computed tomography scan revealed a systemic spread of the disease, with multiple metastases in the liver, bones, and lungs. PSA level was 0.126 ng/ml. A fine needle aspiration biopsy of the liver lesion was undertaken, and the histopathologic examination revealed the prostatic origin of the metastases, so androgen deprivation therapy was started. The diagnosis of metastases should be considered in a patient with prior history of prostate malignancies presenting with solid nodules in the penis, even if the PSA level is low.

  14. A randomised controlled trial of the effects of a web-based PSA decision aid, Prosdex. Protocol

    Directory of Open Access Journals (Sweden)

    Griffiths Jeff

    2007-10-01

    Full Text Available Abstract Background Informed decision making is the theoretical basis in the UK for men's decisions about Prostate Specific Antigen (PSA testing for prostate cancer testing. The aim of this study is to evaluate the effect of a web-based PSA decision-aid, Prosdex, on informed decision making in men. The objective is to assess the effect of Prosdex on six specific outcomes: (i knowledge of PSA and prostate cancer-related issues – the principal outcome of the study; (ii attitudes to testing; (iii decision conflict; (iv anxiety; (v intention to undergo PSA testing; (vi uptake of PSA testing. In addition, a mathematical simulation model of the effects of Prosdex will be developed. Methods A randomised controlled trial with four groups: two intervention groups, one viewing Prosdex and the other receiving a paper version of the site; two control groups, the second controlling for the potential Hawthorn effect of the questionnaire used with the first control group. Men between the ages of 50 and 75, who have not previously had a PSA test, will be recruited from General Practitioners (GPs in Wales, UK. The principal outcome, knowledge, and four other outcome measures – attitudes to testing, decision conflict, anxiety and intention to undergo testing – will be measured with an online questionnaire, used by men in three of the study groups. Six months later, PSA test uptake will be ascertained from GP records; the online questionnaire will then be repeated. These outcomes, and particularly PSA test uptake, will be used to develop a mathematical simulation model, specifically to consider the impact on health service resources. Trial registration Current Controlled Trial: ISRCTN48473735.

  15. Recombinant Forms of Leishmania amazonensis Excreted/Secreted Promastigote Surface Antigen (PSA Induce Protective Immune Responses in Dogs.

    Directory of Open Access Journals (Sweden)

    Elodie Petitdidier

    2016-05-01

    Full Text Available Preventive vaccination is a highly promising strategy for interrupting leishmaniasis transmission that can, additionally, contribute to elimination. A vaccine formulation based on naturally excreted secreted (ES antigens was prepared from L. infantum promastigote culture supernatant. This vaccine achieved successful results in Phase III trials and was licensed and marketed as CaniLeish. We recently showed that newly identified ES promastigote surface antigen (PSA, from both viable promastigotes and axenically-grown amastigotes, represented the major constituent and the highly immunogenic antigen of L. infantum and L. amazonensis ES products. We report here that three immunizations with either the recombinant ES LaPSA-38S (rPSA or its carboxy terminal part LaPSA-12S (Cter-rPSA, combined with QA-21 as adjuvant, confer high levels of protection in naive L. infantum-infected Beagle dogs, as checked by bone marrow parasite absence in respectively 78.8% and 80% of vaccinated dogs at 6 months post-challenge. The parasite burden in infected vaccinated dogs was significantly reduced compared to placebo group, as measured by q-PCR. Moreover, our results reveal humoral and cellular immune response clear-cut differences between vaccinated and control dogs. An early increase in specific IgG2 antibodies was observed in rPSA/QA-21- and Cter-rPSA/QA-21-immunized dogs only. They were found functionally active in vitro and were highly correlated with vaccine protection. In vaccinated protected dogs, IFN-γ and NO productions, as well as anti-leishmanial macrophage activity, were increased. These data strongly suggest that ES PSA or its carboxy-terminal part, in recombinant forms, induce protection in a canine model of zoonotic visceral leishmaniasis by inducing a Th1-dominant immune response and an appropriate specific antibody response. These data suggest that they could be considered as important active components in vaccine candidates.

  16. Recombinant Forms of Leishmania amazonensis Excreted/Secreted Promastigote Surface Antigen (PSA) Induce Protective Immune Responses in Dogs.

    Science.gov (United States)

    Petitdidier, Elodie; Pagniez, Julie; Papierok, Gérard; Vincendeau, Philippe; Lemesre, Jean-Loup; Bras-Gonçalves, Rachel

    2016-05-01

    Preventive vaccination is a highly promising strategy for interrupting leishmaniasis transmission that can, additionally, contribute to elimination. A vaccine formulation based on naturally excreted secreted (ES) antigens was prepared from L. infantum promastigote culture supernatant. This vaccine achieved successful results in Phase III trials and was licensed and marketed as CaniLeish. We recently showed that newly identified ES promastigote surface antigen (PSA), from both viable promastigotes and axenically-grown amastigotes, represented the major constituent and the highly immunogenic antigen of L. infantum and L. amazonensis ES products. We report here that three immunizations with either the recombinant ES LaPSA-38S (rPSA) or its carboxy terminal part LaPSA-12S (Cter-rPSA), combined with QA-21 as adjuvant, confer high levels of protection in naive L. infantum-infected Beagle dogs, as checked by bone marrow parasite absence in respectively 78.8% and 80% of vaccinated dogs at 6 months post-challenge. The parasite burden in infected vaccinated dogs was significantly reduced compared to placebo group, as measured by q-PCR. Moreover, our results reveal humoral and cellular immune response clear-cut differences between vaccinated and control dogs. An early increase in specific IgG2 antibodies was observed in rPSA/QA-21- and Cter-rPSA/QA-21-immunized dogs only. They were found functionally active in vitro and were highly correlated with vaccine protection. In vaccinated protected dogs, IFN-γ and NO productions, as well as anti-leishmanial macrophage activity, were increased. These data strongly suggest that ES PSA or its carboxy-terminal part, in recombinant forms, induce protection in a canine model of zoonotic visceral leishmaniasis by inducing a Th1-dominant immune response and an appropriate specific antibody response. These data suggest that they could be considered as important active components in vaccine candidates.

  17. Selective Activation of a Perforin-Granzyme B Fusion Protein Toxin by PSA as Therapy for Metastatic Prostate Cancer

    Science.gov (United States)

    2016-10-01

    SUPPLEMENTARY NOTES 14. ABSTRACT Protein toxins represent a class of agents that can kill cells in a proliferation independent manner. Many such...PSA and PSMA 15. SUBJECT TERMS Granzyme B, PSA, PSMA, protoxin, protease, zymogen 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18...NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON a. REPORT b. ABSTRACT c. THIS PAGE 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8

  18. Evaluation of the Impact That PARs Have on the Hydrogen Risk in the Reactor Containment: Methodology and Application to PSA Level 2

    Directory of Open Access Journals (Sweden)

    Ahmed Bentaib

    2010-01-01

    Full Text Available This paper presents a methodology and its application to a Level 2 Probabilistic Safety Assessment (PSA-2, to evaluate the impact of the Passive Autocatalytic Recombiners (PARs on the hydrogen risk in the reactor containment in case of a severe accident. Among the whole set of accidental scenarios calculated in the framework of the PSA-2, nine have been selected as representative in terms of the in-vessel hydrogen production rate and in-vessel total produced hydrogen mass. Five complementary scenarios have been added as representative of the core reflooding situations. For this set of selected scenarios the evolution of the conditions in the containment (i.e., pressure, temperature, and composition during the in-vessel phase of the accident has been evaluated by means of a lumped parameter approach. The use of spray systems in the containment has also been considered as well as the presence of recombiners. Moreover, the ignition by recombiners of the flammable atmosphere has been considered.