The Value of Cervical Screening in Women over 50 Years of Age —Time for a Multicentre Audit

1998 ◽  
Vol 43 (1) ◽  
pp. 19-20 ◽  
Author(s):  
C.A. McKenzie ◽  
I.D. Duncan
Keyword(s):  
Screening Programme ◽  
Cervical Screening ◽  
Cost Effective ◽  
Older Age ◽  
Age Group ◽  
Cervical Smear ◽  
History Of

This study reviews the cervical smear history of women developing CIN aged over 50 years to consider if they might be discharged sooner from the cervical screening programme in Tayside Region. From the OCCURS database all women over 50 years who developed CIN between 1 Jan 1993 and 30 June 1996 were identified and their smear history obtained. Results show that had women been discharged from the screening programme at age 50 following three consecutive negative smears and a negative exit smear then only two women with CIN3 and one with microinvasive disease would have been missed in the subsequent three and a half years. A wider geographical survey of the incidence of CIN in this older age group is needed to determine whether it is cost beneficial and cost effective to continue cervical screening beyond the age of 50 years.

scholarly journals Age-related differences in risk profile among Bangladeshi adults suffering from stable angina

2020 ◽  
Vol 7 (11) ◽  
pp. 1619
Author(s):  
Solaiman Mia ◽  
Goutam Kumar Acherjya ◽  
Paritosh Kumar Ghosh ◽  
Mahfuzur Rahman ◽  
Quazi S. Islam
Keyword(s):  
Stable Angina ◽  
Risk Profile ◽  
Older Age ◽  
Diabetic Patients ◽  
Age Group ◽  
Female Ratio ◽  
Multiple Risk Factors ◽  
Age Related ◽  
History Of ◽  
Study Population

Background: We aimed to find out the age-related differences in risk profile among Bangladeshi adults suffering from stable angina.Methods: An observational study was conducted in three different districts in Bangladesh (Feni, Noakhali and Chandpur) through the medical camps during the period from 1st February 2018 to 31st July 2018. Data of 764 stable angina patients was analysed.Results: The male to female ratio in both groups was 4:1. The mean age of the study population in younger group was 34.0±5.2 years and in older group 57.0±6.3 years. Smokers were more in younger group (70.0% vs. 46.0%; p=0.032). Hypertension was less in the younger group (38.0% vs. 58.0%) (p=0.045). Presence of diabetes was higher in the older age group (34.0% vs. 4.0%) (p=0.001). The total cholesterol was higher in older group (182.9±33.1) vs. (171.1±24.8 mg/dl) (p=0.047). 68% of patients of older group and 38% of younger group had stenosis in left anterior descending artery (p=0.003). The involvement of left circumflex and right coronary artery in older age group were higher (56% and 66% respectively) than those in younger group (36% and 40% respectively) (p=0.045 and p=0.009). Patients had multiple risk factors like hypertension, family history of cardiovascular disease, smoking and ischemic heart disease (IHD).Conclusions: This study found that the incidence of IHD is very among the district-level diabetic patients of Bangladesh and this incidence increases with the rise of age.

scholarly journals Rates of cervical screening amongst females admitted to the psychiatric inpatient hospital in Jersey, Channel Islands

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S228-S229
Author(s):  
Jade Wright
Keyword(s):  
General Population ◽  
Physical Health ◽  
Cervical Screening ◽  
Psychiatric Inpatient ◽  
Inclusion Criteria ◽  
Cervical Smear ◽  
National Guidelines ◽  
Inpatient Hospital ◽  
History Of ◽  
Screening History

AimsPatients with enduring mental health conditions are known to have higher morbidity and mortality rates than the general population. It has been identified that this is due to lifestyle risk factors, medication side effects and barriers to receiving physical health care. National screening programmes; including cervical screening, save lives, however depends upon patient engagement. We hypothesised that due to the factors stated above, psychiatric inpatients are more at risk of cervical cancer and less likely to engage in cervical screening. This study aimed to assess the cervical screening history of patients discharged from the psychiatric inpatient hospital in Jersey, Channel Islands.MethodUsing computerised laboratory records, the cervical smear history of female patients discharged from the paychiatric inpatient hospital was analysed. Inclusion criteria were: being aged between 25–64 years and having a cervix in situ. Exclusion criteria were total hysterectomy. Cervical smear history was compared to the national guidelines of having routine smears every 3 years for women aged 25–49 and every 5 years for women aged between 50–64 years.ResultIn the period 1 December 2019–1 December 2020 there were 45 females discharged from the psychiatric inpatient hospital that fit the inclusion criteria. 26 (58%) were up to date with their cervical smears in accordance with national guidelines. 12 (27%) had previously had a smear but were not up to date. 19 smears were done at the GP, 13 at the sexual health clinic and 6 at gynaecology clinic. 7 (16%) had never had a cervical smear. Of these 7 patients it was identified that one patient was in a same sex relationship and one was a victim of sexual assault.Conclusion58% of women discharged from the psychiatric inpatient hospital were up to date with their smears. This is down from the 72.2% coverage rate of the general population. Although this was a small study, it highlights that engagement with cervical screening amongst psychiatric inpatients is less than the general population. Admission presents a crucial contact between patients and healthcare services and this could be utilised to engage patients in physical health screening. Cervical screening history could be checked upon admission and patients not adequately screened, assisted to make an appointment on discharge.

scholarly journals Demographic Characteristics of COVID-19 Patients in District Gujrat

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 56-62
Author(s):  
Hussnain Ashraf Gondal ◽  
Hassan Mumtaz ◽  
Irfan Afzal Mughal ◽  
Noor-ul-Ain Irfan ◽  
Shamim Mumtaz ◽  
...  
Keyword(s):  
Age Groups ◽  
Female Gender ◽  
Young Age ◽  
Older Age ◽  
Common Symptom ◽  
Age Group ◽  
Chi Square ◽  
Travel History ◽  
Cardiac Symptoms ◽  
History Of

Objective: To determine the prevalence of Covid-19 in the district of Gujrat, its association with gender, age, its correlation with respiratory and cardiac symptoms and to find the link of this disease with travel history of patients to affected areas. Methodology: A total of 222 COVID-19 -Positive patients (Male and Female) out of 514 clinically suspected cases (fever, cough, dyspnoea, lethargy & anosmia) as per WHO guidelines were selected. The use of the data for research purposes was explained to patients, and informed consent was taken. The study was approved by the ethical committee of Aziz Bhatti Shaheed Hospital. Samples were extracted from nasopharyngeal swabs using standard extraction protocol. Statistical tools used was SPSS Version 24. Chi-square test and correlation of age with respiratory and cardiac symptoms was calculated. Results: Male gender was significantly affected by this disease (P=0.001) as compared to the female gender. Regarding the prevalence of respiratory symptoms, 31(14%) were asymptomatic. 37(16.7%) had Dyspnea, 45 (65.3%) cough (P= 0.001). Nine (4.1%) developed pneumonia. Fever and Cough was the most common symptom in the age group 21-40 yrs(P=0.001). While pneumonia developed in the older age group. The cardiac symptoms appeared in young age group (p=0.000) in the age group 21-40 yrs (70.9% n=78).38 patients (17.2%) had the symptom of chest pain, 24(10.9%) tachycardia and 1(0.5%) developed arrhythmia. Out of 222 COVID positive patients, 67.1% (149) gave a history of direct contact with positive patients, 19.8% (n=44) gave travel history,4.5% (n=10) had a history of going to Raiwind Ijtamah and 8.6% (n=19) were zaireen/pilgrims from Taftan. Conclusion: The COVID -19 is comparatively more common in male patients. 50% of the patients were of age group 21-40 years showing the symptoms of fever and cough along with mild cardiac symptoms. Acute pneumonia developed in older age groups while cardiac symptoms were significant in young age. In Gujrat District, the majority of the patients (67.1%) developed Covid-19 due to travelling.

scholarly journals The risk factors of measles outbreak in Dollo zone Somali region, Ethiopia

2021 ◽  
Vol 8 (11) ◽  
pp. 5179
Author(s):  
Abdisalan M. Ali ◽  
Mohammed A. Maalin
Keyword(s):  
Age Groups ◽  
Immunization Coverage ◽  
Cost Effective ◽  
Effective Vaccine ◽  
Age Group ◽  
African Region ◽  
Susceptible Population ◽  
Measles Outbreak ◽  
Viral Illness ◽  
History Of

Background: Measles is a highly contagious acute viral illness with the possibility of severe and dangerous complications. Measles occurrence is related to urbanization because of high entry of migrants and high population density; cities have become important hubs for the spread of infectious diseases. The African region is a crucial player in the global fight against measles and has made tremendous progress in its effort to immunize children and to control the disease. Despite the accessibility of safe and cost-effective vaccine, measles has remained endemic with persistent periodic outbreaks in the horn of Africa.Methods: We reviewed the measles cases line lists in Dollo zone from January 2017 to March 2018. There was a total of 771-line listed cases in 2017 and 326 line-listed in 2018. Measles case investigations on alerts were also reviewed when there is an alert rumors verification case investigation done. The line list included variables on vaccination status, age, sex, treatment modality, date of onset the rash, date seen health facility, diagnosis, outcome (alive or dead), locations from place cases came from, contact history and travel history were reviewed.Results: We found that the measles outbreak affected different age groups in Dollo zone and most affected age group were between the ages of 15 years to 30 years and most of the cases have no history of immunization.Conclusions: The outbreak affected all age groups, which may show the continuous low routine immunization coverage over several years and the gathering of the susceptible population in the older age group that may have led to the current outbreak.

scholarly journals Improving uptake of cervical cancer screening in women with prolonged history of non-attendance for screening: a randomized trial of enhanced invitation methods

2005 ◽  
Vol 12 (4) ◽  
pp. 185-189 ◽  
Author(s):  
K Stein ◽  
G Lewendon ◽  
R Jenkins ◽  
C Davis
Keyword(s):  
Cost Effectiveness ◽  
Screening Programme ◽  
Controlled Trial ◽  
Cervical Screening ◽  
Routine Data ◽  
Telephone Call ◽  
Control Group ◽  
Routine Practice ◽  
Telephone Intervention ◽  
History Of

Objective: To compare the effectiveness and cost-effectiveness of three methods of inviting women with a long history of non-attendance to undergo cervical screening. Methods: Randomized controlled trial and cost-effectiveness analysis. In all, 1140 women were identified from routine NHS screening records as having no smear for at least 15 years and randomly allocated to receive a telephone call from a nurse, a letter from a well-known celebrity (Claire Rayner) or letter from the local NHS Cervical Screening Commissioner. Uptake of screening was measured using routine data and attributed to interventions if occurring within three months. Uptake was compared with a control group. Costs of carrying out the interventions were noted from the perspective of the NHS and cost-effectiveness, as cost per additional attender, calculated. Results: Uptake following all interventions was low: telephone call (1.4, 95% confidence interval [CI] 0.38–3.6%); celebrity letter (1.8, 95% CI 0.57–4.0%); commissioner letter (4.6, 95% CI 2.5–7.7%); control group (1.8, 95% CI 0.57–4.0%). There were no significant differences between groups. Telephone intervention was not possible in a quarter of women whose numbers were unlisted. Telephone intervention was the most expensive and least effective of the interventions. The commissioner letter yielded an additional attender within three months at an incremental cost of £23.21 compared with taking no action. Conclusions: Neither a telephone call from a nurse nor a letter from a celebrity to encourage attendance for cervical screening were effective or cost-effective in women with a prolonged history of non-participation in the screening programme. A letter from the local cervical screening programme commissioner resulted in a small, non-significant increase in uptake. The low cost and ease of implementation of this intervention supports further research into its use in routine practice.

Hereditary Heparin Cofactor II Deficiency and the Risk of Development of Thrombosis

1987 ◽  
Vol 57 (02) ◽  
pp. 196-200 ◽  
Author(s):  
R M Bertina ◽  
I K van der Linden ◽  
L Engesser ◽  
H P Muller ◽  
E J P Brommer
Keyword(s):  
Liver Disease ◽  
Venous Thrombosis ◽  
Healthy Volunteers ◽  
Mean Value ◽  
Age Group ◽  
Normal Range ◽  
Heparin Cofactor Ii ◽  
History Of ◽  
Group 2 ◽  
Hereditary Nature

SummaryHeparin cofactor II (HC II) levels were measured by electroimmunoassay in healthy volunteers, and patients with liver disease, DIC, proteinuria or a history of venous thrombosis. Analysis of the data in 107 healthy volunteers revealed that plasma HC II increases with age (at least between 20 and 50 years). HC II was found to be decreased in most patients with liver disease (mean value: 43%) and only in some patients with DIC. Elevated levels were found in patients with proteinuria (mean value 145%). In 277 patients with a history of unexplained venous thrombosis three patients were identified with a HC II below the lower limit of the normal range (60%). Family studies demonstrated hereditary HC II deficiency in two cases. Among the 9 heterozygotes for HC II deficiency only one patient had a well documented history of unexplained thrombosis. Therefore the question was raised whether heterozygotes for HC II deficiency can also be found among healthy volunteers. When defining a group of individuals suspected of HC II deficiency as those who have a 90% probability that their plasma HC II is below the 95% tolerance limits of the normal distribution in the relevant age group, 2 suspected HC II deficiencies were identified among the healthy volunteers. In one case the hereditary nature of the defect could be established.It is concluded that hereditary HC II deficiency is as prevalent among healthy volunteers as in patients with thrombotic disease. Further it is unlikely that heterozygosity for HC II deficiency in itself is a risk factor for the development of venous thrombosis.

Study of cervical smear examination in women between 18 - 70 years age group

2020 ◽  
Vol 14 (2) ◽  
pp. 30-33
Author(s):  
Srujal Patel ◽  
◽  
Kinara Patel ◽  
Jignasa Bhalodia ◽  
◽  
...  
Keyword(s):  
Age Group ◽  
Cervical Smear ◽  
Smear Examination

scholarly journals Screening for Melanoma by Primary Health Care Physicians: A Cost—Effectiveness Analysis

1996 ◽  
Vol 3 (1) ◽  
pp. 47-53 ◽  
Author(s):  
Afaf Girgis ◽  
Philip Clarke ◽  
Robert C Burton ◽  
Rob W Sanson—Fisher
Keyword(s):  
Cost Effectiveness ◽  
Screening Programme ◽  
Cost Effective ◽  
Economic Assessment ◽  
Screening Tests ◽  
Family Practitioners ◽  
Effectiveness Analysis ◽  
The Cost ◽  
Primary Health Care Physicians ◽  
Melanoma Screening

Background and design— Australia has the highest rates of skin cancer in the world, and the incidence is estimated to be doubling every 10 years. Despite advances in the early detection and treatment of melanoma about 800 people still die nationally of the disease each year. A possible strategy for further reducing the mortality from melanoma is an organised programme of population screening for unsuspected lesions in asymptomatic people. Arguments against introducing melanoma screening have been based on cost and the lack of reliable data on the efficacy of any screening tests. To date, however, there has been no systematic economic assessment of the cost effectiveness of melanoma screening. The purpose of this research was to determine whether screening may be potentially cost effective and, therefore, warrants further investigation. A computer was used to simulate the effects of a hypothetical melanoma screening programme that was in operation for 20 years, using cohorts of Australians aged 50 at the start of the programme. Based on this simulation, cost—effectiveness estimates of melanoma screening were calculated. Results— Under the standard assumptions used in the model, and setting the sensitivity of the screening test (visual inspection of the skin) at 60%, cost effectiveness ranged from Aust$6853 per life year saved for men if screening was undertaken five yearly to $12137 if screening was two yearly. For women, it ranged from $11 102 for five yearly screening to $20 877 for two yearly screening. Conclusion— The analysis suggests that a melanoma screening programme could be cost effective, particularly if five yearly screening is implemented by family practitioners for men over the age of 50.

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