Mass screening

About: Mass screening is a research topic. Over the lifetime, 34508 publications have been published within this topic receiving 1365148 citations.

Hand-Grip Strength Cut-Points to Screen Older Persons at Risk for Mobility Limitation

Abstract: Objectives To determine optimal hand-grip strength cut points for likelihood of mobility limitation in older people and to study whether these cut points differ according to body mass index (BMI). Design Cross-sectional analysis of data. Setting Data collected in the Finnish population-based Health 2000 Survey. Participants One thousand eighty-four men and 1,562 women aged 55 and older with complete data on anthropometry, hand-grip strength and self-reported mobility. Measurements Mobility limitation was defined as difficulty walking 0.5 km or climbing stairs. Receiver operating characteristic analysis was used to estimate hand-grip strength cut points for likelihood of mobility limitation. Results The overall hand-grip strength cut points for likelihood of mobility limitation were 37 kg (sensitivity 62%; specificity 76%) for men and 21 kg (sensitivity 67%; specificity 73%) for women. The effect of the interaction between hand-grip strength and BMI on mobility limitation was significant in men (P=.02), but no such interaction was observed in women (P=.16). In men, the most-optimal cutoff points were 33 kg (sensitivity 73%; specificity 79%) for normal-weight men, 39 kg (sensitivity 67%; specificity 71%) for overweight men, and 40 kg (sensitivity 57%; specificity 68%) for obese men. In women, BMI-specific hand-grip strength cutoff values was not markedly more accurate than the overall cutoff value. Conclusion The hand-grip strength test is a useful tool to identify persons at risk of mobility limitation. In men, hand-grip strength cut points for mobility increased with BMI, whereas in women, only one hand-grip strength threshold was identified.

Infection Risk and Safety of Corticosteroid Use

Abstract: Corticosteroids are frequently used to treat rheumatic diseases. Their use comes with several well-established risks, including osteoporosis, avascular necrosis, glaucoma, and diabetes. The risk of infection is of utmost concern and is well documented, although randomized controlled trials of short-term and lower-dose steroids have generally shown little or no increased risk. Observational studies from the real world, however, have consistently shown dose-dependent increases in risk for serious infections as well as certain opportunistic infections. In patients who begin chronic steroid therapy, vaccination and screening strategies should be used in an attempt to mitigate this risk.

Breast tumor characteristics as predictors of mammographic detection: comparison of interval- and screen-detected cancers.

Abstract: Background Although mammographic screening is useful for detecting early breast cancer, some tumors are detected in the interval between screening examinations. This study attempted to characterize fully the tumors detected in the two different manners. Methods Our study utilized a case-control design and involved a cohort of women undergoing mammographic screening within the defined population of a health maintenance organization (the Group Health Cooperative of Puget Sound). Women were classified as having "interval" or "interval-detected" cancers (n = 150) if their diagnosis was made within 24 months after a negative-screening mammogram or one that indicated a benign condition. Cancers were classified as "screen detected" (n = 279) if the diagnosis occurred after a positive assessment by screening mammography. Tumors from women in each group were evaluated for clinical presentation, histology, proliferative characteristics, and expression of hormone receptors, p53 tumor suppressor protein, and c-erbB-2 protein. Results Interval-detected cancers occurred more in younger women and were of larger tumor size than screen-detected cancers. In unconditional logistic regression models adjusted for age and tumor size, tumors with lobular (odds ratio [OR] = 1.9; 95% confidence interval [CI] = 0.9-4.2) or mucinous (OR = 5.5; 95% CI = 1.5-19.4) histology, high proliferation (by either mitotic count [OR = 2.9; 95% CI = 1.5-5.7] or Ki-67 antigen expression [OR = 2.3; 95% CI = 1.3-4.1]), high histologic grade (OR = 2.1; 95% CI = 1.2-4.0), high nuclear grade (OR = 2.0; 95% CI = 1.0-3.7), or negative estrogen receptor status (OR = 1.8; 95% CI = 1.0-3.1) were more likely to surface in the interval between screening examinations. Tumors with tubular histology (OR = 0.2; 95% CI = 0.0-0.8) or with a high percentage of in situ components (50%) (OR = 0.5; 95% CI = 0.2-1.2) were associated with an increased likelihood of screen detection. Conclusions Our data from a large group of women in a defined population indicate that screening mammography may miss tumors of lobular or mucinous histology and some rapidly proliferating, high-grade tumors.