scholarly journals Faecal Haemoglobin Estimated by Faecal Immunochemical Tests—An Indicator of Systemic Inflammation with Real Clinical Potential

Diagnostics ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. 2093
Author(s):  
Karen N. Barnett ◽  
Gavin R. C. Clark ◽  
Robert J. C. Steele ◽  
Callum G. Fraser
Keyword(s):  
At Risk ◽  
Chronic Disease ◽  
Early Stage ◽  
Gastrointestinal Symptoms ◽  
Haemoglobin Concentration ◽  
Premature Death ◽  
Developed Countries ◽  
Immunochemical Test ◽  
Clinical Potential ◽  
Obvious Source

Multimorbidity is the major cause of ill-health and premature death in developed countries. The ability to identify individuals at risk of developing chronic disease, particularly multimorbidity, reliably, and simply, and to identify undiagnosed disorders, is vital to reducing the global burden of disease. This narrative review, the first of recent studies, demonstrates that raised faecal haemoglobin concentration (f-Hb) is associated with increased all-cause and cause-specific mortality and with longer-term conditions including diabetes, hypertension, cardiovascular disease, and psoriasis, and with probable intake of particulate matter. We and others have hypothesized that elevated f-Hb (measured using a faecal immunochemical test) has considerable potential to identify individuals at risk of, or who already have, early stage, undiagnosed chronic disease. If f-Hb does prove to be an effective biomarker for chronic disease and multimorbidity, individuals with detectable f-Hb, but without an obvious source of gastrointestinal blood loss, could benefit from further assessment and early intervention. To test this hypothesis rigorously, longitudinal data-linkage methodology is required linking colorectal cancer screening data, and data on patients presenting with lower gastrointestinal symptoms, with routinely collected health information.

scholarly journals The APAC Score: A Novel and Highly Performant Serological Tool for Early Diagnosis of Hepatocellular Carcinoma in Patients with Liver Cirrhosis

2021 ◽  
Vol 10 (15) ◽  
pp. 3392
Author(s):  
Joeri Lambrecht ◽  
Mustafa Porsch-Özçürümez ◽  
Jan Best ◽  
Fabian Jost-Brinkmann ◽  
Christoph Roderburg ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
At Risk ◽  
Liver Cirrhosis ◽  
Early Stage ◽  
Treatment Options ◽  
Growth Factor Receptor ◽  
Serum Samples ◽  
Disease Etiology ◽  
Risk Patients ◽  
Scoring Tool

(1) Background: Surveillance of at-risk patients for hepatocellular carcinoma (HCC) is highly necessary, as curative treatment options are only feasible in early disease stages. However, to date, screening of patients with liver cirrhosis for HCC mostly relies on suboptimal ultrasound-mediated evaluation and α-fetoprotein (AFP) measurement. Therefore, we sought to develop a novel and blood-based scoring tool for the identification of early-stage HCC. (2) Methods: Serum samples from 267 patients with liver cirrhosis, including 122 patients with HCC and 145 without, were collected. Expression levels of soluble platelet-derived growth factor receptor beta (sPDGFRβ) and routine clinical parameters were evaluated, and then utilized in logistic regression analysis. (3) Results: We developed a novel serological scoring tool, the APAC score, consisting of the parameters age, sPDGFRβ, AFP, and creatinine, which identified patients with HCC in a cirrhotic population with an AUC of 0.9503, which was significantly better than the GALAD score (AUC: 0.9000, p = 0.0031). Moreover, the diagnostic accuracy of the APAC score was independent of disease etiology, including alcohol (AUC: 0.9317), viral infection (AUC: 0.9561), and NAFLD (AUC: 0.9545). For the detection of patients with (very) early (BCLC 0/A) HCC stage or within Milan criteria, the APAC score achieved an AUC of 0.9317 (sensitivity: 85.2%, specificity: 89.2%) and 0.9488 (sensitivity: 91.1%, specificity 85.3%), respectively. (4) Conclusions: The APAC score is a novel and highly accurate serological tool for the identification of HCC, especially for early stages. It is superior to the currently proposed blood-based algorithms, and has the potential to improve surveillance of the at-risk population.

scholarly journals Primary Care Networks and Starfield’s 4Cs: A Case for Enhanced Chronic Disease Management

2021 ◽  
Vol 18 (6) ◽  
pp. 2926
Author(s):  
Chuan De Foo ◽  
Shilpa Surendran ◽  
Geronimo Jimenez ◽  
John Pastor Ansah ◽  
David Bruce Matchar ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Disease Management ◽  
Chronic Disease Management ◽  
Early Stage ◽  
Healthcare Delivery ◽  
Stage Of Development ◽  
Facilitators And Barriers ◽  
Design Options ◽  
First Contact

The primary care network (PCN) was implemented as a healthcare delivery model which organises private general practitioners (GPs) into groups and furnished with a certain level of resources for chronic disease management. A secondary qualitative analysis was conducted with data from an earlier study exploring facilitators and barriers GPs enrolled in PCN’s face in chronic disease management. The objective of this study is to map features of PCN to Starfield’s “4Cs” framework. The “4Cs” of primary care—comprehensiveness, first contact access, coordination and continuity—offer high-quality design options for chronic disease management. Interview transcripts of GPs (n = 30) from the original study were purposefully selected. Provision of ancillary services, manpower, a chronic disease registry and extended operating hours of GP practices demonstrated PCN’s empowering features that fulfil the “4Cs”. On the contrary, operational challenges such as the lack of an integrated electronic medical record and disproportionate GP payment structures limit PCNs from maximising the “4Cs”. However, the enabling features mentioned above outweighs the shortfalls in all important aspects of delivering optimal chronic disease care. Therefore, even though PCN is in its early stage of development, it has shown to be well poised to steer GPs towards enhanced chronic disease management.

scholarly journals Current and Emerging Pharmacotherapeutic Options for Smoking Cessation

2013 ◽  
Vol 7 ◽  
pp. SART.S8108 ◽  
Author(s):  
Kristin V. Carson ◽  
Malcolm P. Brinn ◽  
Thomas A. Robertson ◽  
Rachada To-A-Nan ◽  
Adrian J. Esterman ◽  
...  
Keyword(s):  
Developing Countries ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Chronic Disease ◽  
Developed Countries ◽  
Mental Illnesses ◽  
Current Clinical Practice ◽  
Efficacy And Safety ◽  
First Line ◽  
Marginalized Groups

Tobacco smoking remains the single most preventable cause of morbidity and mortality in developed countries and poses a significant threat across developing countries where tobacco use prevalence is increasing. Nicotine dependence is a chronic disease often requiring multiple attempts to quit; repeated interventions with pharmacotherapeutic aids have become more popular as part of cessation therapies. First-line medications of known efficacy in the general population include varenicline tartrate, bupropion hydrochloride, nicotine replacement therapy products, or a combination thereof. However, less is known about the use of these products in marginalized groups such as the indigenous, those with mental illnesses, youth, and pregnant or breastfeeding women. Despite the efficacy and safety of these first line pharmacotherapies, many smokers continue to relapse and alternative pharmacotherapies and cessation options are required. Thus, the aim of this review is to summarize the existing and developing pharmacotherapeutic and other options for smoking cessation, to identify gaps in current clinical practice, and to provide recommendations for future evaluations and research.

Reproductive Failure in Populations of the Dog-Whelk, Nucella Lapillus, Caused by Imposex Induced by Tributyltin from Antifouling Paints

1986 ◽  
Vol 66 (4) ◽  
pp. 767-777 ◽  
Author(s):  
P. E. Gibbs ◽  
G. W. Bryan
Keyword(s):  
Vas Deferens ◽  
Early Stage ◽  
Premature Death ◽  
Intermediate Stage ◽  
Reproductive Failure ◽  
Nucella Lapillus ◽  
Egg Capsules ◽  
Male Characters ◽  
High Incidence ◽  
Declining Populations

The development of male characters, notably a penis and a vas deferens, on the female (the phenomenon of ‘imposex’) of the dog-whelk, Nucella lapillus, is described. Three stages are recognized: an ‘early’ stage involving the formation of a vas deferens and a small penis, an ‘intermediate’ stage characterized by the enlargement of the female penis to a size approaching that of the male and a ‘late’ stage during which the female opening (vulva) is occluded by overgrowth of vas deferens tissue. This blockage of the pallial oviduct prevents the release of egg capsules and renders the female sterile. The extent and cause of such reproductive failure is evident from the high incidence of females containing aborted capsules in declining populations close to sources of tributyltin (TBT) contamination. These same populations comprise fewer females than expected and it would appear that the accumulation of aborted capsules within the pallial oviduct eventually causes the premature death of the female.

Prognostic Molecular Assay Might Improve Identification of Patients At Risk for Recurrence in Early-Stage Non–Small-Cell Lung Cancer

2014 ◽  
Vol 15 (6) ◽  
pp. 426-432 ◽  
Author(s):  
Gavitt A. Woodard ◽  
Matthew A. Gubens ◽  
Thierry M. Jahan ◽  
Kirk D. Jones ◽  
Jasleen Kukreja ◽  
...  
Keyword(s):  
Lung Cancer ◽  
At Risk ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Early Stage ◽  
Small Cell ◽  
Molecular Assay ◽  
Small Cell Lung ◽  
Patients At Risk

Prevalence of non-pathogenic types of gastrointestinal protozoa in population in Slovakia and their potential importance in the aspect of public health

2018 ◽  
Vol 63 (4) ◽  
pp. 819-825 ◽  
Author(s):  
Adriána Dudlová ◽  
Pavol Jarčuška ◽  
Silvia Jurišová ◽  
Zuzana Vasilková ◽  
Vladimír Krčméry ◽  
...  
Keyword(s):  
Human Population ◽  
Statistical Significance ◽  
Age Groups ◽  
Gastrointestinal Symptoms ◽  
Developed Countries ◽  
Age Group ◽  
Potential Importance ◽  
Blastocystis Hominis ◽  
Factors Affecting ◽  
Total Prevalence

Abstract The aim of the research was to determine the prevalence of non-pathogenic protozoa circulating in the human population of Slovakia. We particularly focused on the socially deprived areas with poor sanitation conditions, as they are one of the factors affecting the transmission of these infections. Within this study, 2760 people were coprologically screened for the presence of protozoan cysts. The analyzed group comprised 1173 men and 1587 women from different regions of Slovakia. The total prevalence (2.03%) of non-pathogenic protozoa species was determined. The prevalence of Entamoeba coli was 0.80%, the prevalence of Endolimax nana 0.58%, and the prevalence of Blastocystis hominis was 0.65%. The presence of non-pathogenic protozoa was more frequent in women than that in men, in all age groups. The highest incidence of Entamoeba coli was found in children aged one month – seven years (0.79%), the lowest in the age group of 19–88 years (0.66%). Endolimax nana was most frequent in 8–18 year-olds (0.95%), where the statistical significance was found (p<0.05). The prevalence of Blastocystis hominis by the age group ranged from 0.39 to 0.95%. We did not find any statistical significance (p>0.05) for Entamoeba coli, and similarly for Blastocystis hominis associated with the sex and age. Although the circulation of non-pathogenic protozoa in the human population is far from being limited to the developing countries, their occurrence is also frequent in the population of developed countries. Despite their controversial pathogenicity, they should not be neglected, particularly in the patients with gastrointestinal symptoms.

scholarly journals Malaria: Trend of Burden and Impact of Control Strategies

2020 ◽  
pp. 18-30
Author(s):  
Emmanuel Ikechukwu Nnamonu ◽  
Pamela Amarachi Ndukwe-Ani ◽  
Cyril Ali Imakwu ◽  
Clara Ifeoma Okenyi ◽  
Felix Joel Ugwu ◽  
...  
Keyword(s):  
Control Strategies ◽  
Premature Death ◽  
Developed Countries ◽  
Mosquito Vector ◽  
Tropical Africa ◽  
Government Interventions ◽  
Malaria Mortality ◽  
Surveillance And Response ◽  
The World ◽  
Giant Leap

Since antiquity, malaria had plagued humans claiming millions of lives annually around the world. In addition to its health toll, billions of dollars are lost every year to the exorbitant cost of treatment, premature death, loss of opportunities, capital intensive public health and government interventions to curb the menace. This had intensified global malaria eradication efforts over the last few decades leading to the successful elimination of the disease from most developed countries drastically reducing global malaria mortality to hundreds of thousands yearly. Still, developing countries of the world especially those in tropical Africa remain the worst hit and children are the most vulnerable group generally accounting for > 50% of all malaria mortality. The world actually experienced a giant leap forward between 2000 and 2015 when global malaria mortality rate declined by a remarkable 25% and by a significant 69% in children less than five. Also, during this period a staggering 70% of malaria cases were averted due to strengthened malaria intervention. Some of this step forward was also attributed to increasing urbanization and overall economic development across the nation’s leading to improved housing and nutrition. However, years later, progress has been relatively slower and seemed to have stalled. Nonetheless, the impacts of control strategies have saved millions of lives universally. But to save more lives and eliminate malaria from highest risk countries like in tropical Africa, more efforts are required at both international and national capacity through the funding of research and malaria projects, effective surveillance and response, strengthened health system and mosquito vector control strategies, and development of new, improved antimalarial intervention tools like diagnostics, prophylactics, therapeutics and vaccines. Also, the role of human activity and lifestyle in the fight against malaria cannot be overemphasized.

scholarly journals Analysis on the Effect of Application of the DIEP Flap in Breast Reconstruction Surgery

2018 ◽  
Vol 2 (1) ◽  
Author(s):  
Tan Jia Liang
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chest Wall ◽  
Early Stage ◽  
Developed Countries ◽  
Breast Cancer Surgery ◽  
Sex Reassignment Surgery ◽  
Diep Flap ◽  
Breast Reduction Surgery ◽  
Reconstruction Surgery

Breast reconstruction surgery means using autologous tissue grafts and breast prosthesis to rebuild chest wall deformities and the absence of breast caused by post mastectomy, which are possibly due to burns, trauma, infections, congenital dysplasia and sex reassignment surgery etc., with the prevalence of unilateral breast reconstruction. After attempting to carry out breast reconstruction with latissimus dorsi, many surgeons constantly improved, designed, and modified multiple forms of operation programs and thus promote increasing improvement in repair and reconstruction of the breast after breast reduction surgery and mastectomy for breast cancer [1] Currently, breast reconstruction after breast cancer surgery is just in the early stage while it has occupied an important position in developed countries,therefore, the knowledge of breast reconstruction needs to be enhanced and publicized in our country. Some data show the quality of life in patients following breast reconstruction surgery is significantly higher than that in patients undergoing lumpectomy plus radiotherapy or simple mastectomy. More and more patients pursue breast reconstruction after mastectomy for breast cancer. Breast reconstruction is roughly divided into lost chest wall skin repair, hemispherical breast reconstruction, anterior axillary fold repair, plastic surgery for subclavian depression, nipple and areola reconstruction and asymmetrical breast repair. In the reconstruction of breasts, it is necessary to endeavor to make the rebuilt breast symmetrical to the healthy side so that future adjustment will be simple and easily feasible.

Why Do We Choose Certain Foods?

2016 ◽  
Vol 78 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Matthew M. Graziose
Keyword(s):  
At Risk ◽  
Chronic Disease ◽  
Genetic Polymorphism ◽  
Eating Behavior ◽  
Food Choice ◽  
Social Experiences

Research into human eating behavior is complex. Innate preferences for sweet and aversions to bitter tastes may explain why we choose certain foods. Some segments of the population, called “supertasters,” are more sensitive to bitter-tasting foods because of a genetic polymorphism. These individuals may reject bitter vegetables like broccoli, potentially putting them at risk for obesity and chronic disease. However, learned associations with food, including rewards, social experiences, and modeling, have also been shown to explain food choice. The respective roles of taste and learning in food choice are explored here in a classroom investigation designed for undergraduates.

Value-at-risk performance in emerging and developed countries

2018 ◽  
Vol 14 (5) ◽  
pp. 591-612
Author(s):  
Luiz Eduardo Gaio ◽  
Tabajara Pimenta Júnior ◽  
Fabiano Guasti Lima ◽  
Ivan Carlin Passos ◽  
Nelson Oliveira Stefanelli
Keyword(s):  
At Risk ◽  
Financial Crises ◽  
Value At Risk ◽  
Risk Estimation ◽  
Developed Countries ◽  
Emerging Countries ◽  
Copula Functions ◽  
Predictive Capacity ◽  
Arch Models ◽  
Content Type

Purpose The purpose of this paper is to evaluate the predictive capacity of market risk estimation models in times of financial crises. Design/methodology/approach For this, value-at-risk (VaR) valuation models applied to the daily returns of portfolios composed of stock indexes of developed and emerging countries were tested. The Historical Simulation VaR model, multivariate ARCH models (BEKK, VECH and constant conditional correlation), artificial neural networks and copula functions were tested. The data sample refers to the periods of two international financial crises, the Asian Crisis of 1997, and the US Sub Prime Crisis of 2008. Findings The results pointed out that the multivariate ARCH models (VECH and BEKK) and Copula-Clayton had similar performance, with good adjustments in 100 percent of the tests. It was not possible to perceive significant differences between the adjustments for developed and emerging countries and of the crisis and normal periods, which was different to what was expected. Originality/value Previous studies focus on the estimation of VaR by a group of models. One of the contributions of this paper is to use several forms of estimation.

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