Background: Does newborn screening for cystic fibrosis (CF) improve clinical outcomes, quality of life and survival?
Objectives: To examine whether newborn screening for CF prevents or reduces irreversible organ damage and improves clinical outcomes, quality of life and survival in people with CF without unacceptable adverse effects.
Search Strategy: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials Register comprising references identified from electronic database searches, handsearches of relevant journals and abstract books of conference proceedings.The Group's Trials Register last searched: June 2008.
Selection Criteria: Randomised or quasi-randomised controlled trials, published and unpublished, comparing screening to clinical diagnosis in people with CF.
Data Collection And Analysis: Two authors independently assessed trial eligibility and quality and independently extracted data. Allocation concealment was unclear in both studies and sequence generation adequate in one.
Main Results: Searches identified six trials. Two trials involving 1,124,483 neonates (210 with CF) with a maximum follow up of 17 years were eligible for inclusion. Varying study designs, outcomes reported and summary measures precluded calculation of pooled estimates and only data from one study were analysed. Severe malnutrition was less common among screened participants. Compared with screened participants, the odds ratio of weight below the tenth percentile was 4.12 (95% CI 1.64 to 10.38) and for height was 4.62 (95% CI 1.69 to 12.61) in the control group.At age seven, 88% of screened participants and 75% of controls had lung function parameters within normal limits of at least 89% predicted. At diagnosis chest radiograph scores were significantly better among screened participants; 33% of screened versus 50% of control participants had Wisconsin chest X-ray (WCXR) scores over five (P = 0.097) and 24% of screened versus 45% of control participants had Brasfield chest X-ray (BCXR) scores under 21 (P = 0.042)). Over time, chest radiograph scores were worse in the screened group (WCXR P = 0.017 and BCXR P = 0.041). Results were no longer significant after adjustment for genotype, pancreatic status, and Pseudomonas aeruginosa-culture results. In screened participants colonisation with Pseudomonas aeruginosa occurred earlier. Estimates suggest diagnosis through screening is less expensive.
Authors' Conclusions: Two randomised controlled trials assessing neonatal screening in CF were identified; data from one study were included. Nutritional benefits are apparent. Screening provides potential for better pulmonary outcomes, but confounding factors influenced long-term pulmonary prognosis of people with CF. Screening seems less expensive than traditional diagnosis.
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http://dx.doi.org/10.1002/14651858.CD001402.pub2 | DOI Listing |
Pacing Clin Electrophysiol
December 2024
Department of Cardiology, Lady Davis Carmel Medical Center, Haifa, Israel.
Background: Pacemaker recipients demonstrate a higher prevalence of atrial fibrillation (AF), yet the regular ventricular activation in pacemaker-dependent patients with AF presents a substantial diagnostic challenge.
Methods: A total of 310 medical practitioners completed a brief, validated survey consisting of three electrocardiograms displaying AF with ventricular pacing. Participants were instructed to identify the underlying rhythm.
Front Glob Womens Health
December 2024
Department of Preventive Medicine and Public Health, Food Science, Toxicology, and Legal Medicine, University of Valencia, Valencia, Spain.
Introduction: Globally, maternal mortality is a major public health problem mainly due to a lack of access to skilled care during childbirth. Maternity waiting homes (MWHs) play a critical role in accessing emergency obstetric care for pregnant women during childbirth. However, available studies show inconsistent findings about women's utilization of maternity waiting homes.
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December 2024
The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China.
Objective: Although there is a strong correlation between stroke and sarcopenia, there has been a lack of research into the potential risks associated with post-stroke sarcopenia. Predictors of sarcopenia are yet to be identified. We aimed at developing a nomogram able to predict sarcopenia in patients with stroke.
View Article and Find Full Text PDFHeliyon
December 2024
AIMS Lab, IRIIC, United International University, Dhaka, Bangladesh.
This paper presents a comprehensive study on the development and performance evaluation of "," a mobile health (mHealth) app designed to facilitate eye screening for impaired visual acuity (VA) in Bangladesh. Recognizing the critical importance of vision and the challenges posed by visual impairments, particularly in low-resource settings, this study explores an innovative solution to enhance eye care accessibility. The app, developed for Android devices, integrates features such as VA testing using adapted Bengali letters, color blindness tests, and eye health education, aiming to make eye care more user-friendly and accessible.
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December 2024
General Surgery, Sunshine Coast University Hospital, Birtinya, AUS.
Cholecystectomy is one of the most commonly performed surgical operations worldwide. A rare complication following this procedure is the migration of surgical clips used to secure the cystic duct and artery. Herein, we report the migration of a metallic surgical clip into the common bile duct of a 75-year-old gentleman who underwent a laparoscopic cholecystectomy 24 years prior.
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