Mass screening

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

Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample.

Abstract: Objective To describe adolescent outcomes of childhood attention-deficit/hyperactivity disorder (ADHD) in a diverse community sample. Method ADHD screening of a school district sample of 1,615 students aged 5 to 11 years was followed by a case-control study 8 years later. High-risk youths meeting full (n = 94) and subthreshold (n = 75) DSM-IV ADHD criteria were matched with demographically similar low-risk peers (n = 163). Outcomes domains included symptom, functional impairment, quality of life, substance use, educational outcomes, and juvenile justice involvement. Results In all, 44% of youths with childhood ADHD had not experienced remission. Compared with unaffected peers, adolescents with childhood ADHD were more likely to display oppositional defiant disorder (odds ratio [OR] = 12.9, 95% confidence interval [CI] 5.6-30.0), anxiety/depression (OR = 10.3, 95% CI 2.7-39.3), significant functional impairment (OR = 3.4, 95% CI 1.7-6.9), reduced quality of life (OR = 2.5, 95% CI 1.3-4.7), and involvement with the juvenile justice system (OR = 3.1, 95% CI 1.0-9.1). Subthreshold ADHD, but not full ADHD, increased the risk of grade retention, whereas both conditions increased the risk of graduation failure. Oppositional defiant disorder (ODD), but not childhood ADHD, increased the risk of cannabis and alcohol use. None of the adolescent outcomes of childhood ADHD were moderated by gender, race or poverty. Conclusions ADHD heralds persistence of ADHD and comorbid symptoms into adolescence, as well as significant risks for functional impairment and juvenile justice involvement. Subthreshold ADHD symptoms typically do not qualify affected students for special educational interventions, yet increase the risk for adverse educational outcomes. Findings stress the importance of early ADHD recognition, especially its comorbid presentation with ODD, for prevention and intervention strategies.

Cost-effectiveness of Colorectal Cancer Screening

Abstract: Colorectal cancer is an important public health problem. Several screening methods have been shown to be effective in reducing colorectal cancer mortality. The objective of this review was to assess the cost-effectiveness of the different colorectal cancer screening methods and to determine the preferred method from a cost-effectiveness point of view. Five databases (MEDLINE, EMBASE, the Cost-Effectiveness Analysis Registry, the British National Health Service Economic Evaluation Database, and the lists of technology assessments of the Centers for Medicare and Medicaid Services) were searched for cost-effectiveness analyses published in English between January 1993 and December 2009. Fifty-five publications relating to 32 unique cost-effectiveness models were identified. All studies found that colorectal cancer screening was cost-effective or even cost-saving compared with no screening. However, the studies disagreed as to which screening method was most effective or had the best incremental cost-effectiveness ratio for a given willingness to pay per life-year gained. There was agreement among studies that the newly developed screening tests of stool DNA testing, computed tomographic colonography, and capsule endoscopy were not yet cost-effective compared with the established screening options.

Stress and health.

Abstract: The impact of stress on physical functioning (endocrine, gastrointestinal, immune, and cardiovascular systems) is reviewed. The effect of stress on psychiatric functioning and health behaviors also is discussed. The importance of stress screening in primary care is emphasized, and several methods of stress reduction (including exercise, cognitive-behavioral therapy, and mindfulness-based stress reduction) appropriate to primary care settings are described.

BK Virus Nephropathy and Kidney Transplantation

Abstract: Nephropathy from BK virus (BKV) infection is an evolving challenge in kidney transplant recipients. It is the consequence of modern potent immunosuppression aimed at reducing acute rejection and improving allograft survival. Untreated BKV infections lead to kidney allograft dysfunction or loss. Decreased immunosuppression is the principle treatment but predisposes to acute and chronic rejection. Screening protocols for early detection and prevention of symptomatic BKV nephropathy have improved outcomes. Although no approved antiviral drug is available, leflunomide, cidofovir, quinolones, and intravenous Ig have been used. Retransplantation after BKV nephropathy has been successful.