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* Context.--Wilms tumor (WT) in adult patients is rare and has historically been a diagnostic and therapeutic conundrum, with limited data available in the literature. Objective.--To provide detailed diagnostic features, molecular profiling, and patient outcomes in a multi-institutional cohort of adult WT patients. Design.--We identified and retrospectively examined 4 adult WT cases. Results.--Two patients presented with metastatic disease, and diagnoses were made on fine-needle aspiration of their renal masses. The aspirates included malignant primitive-appearing epithelioid cells forming tubular rosettes and necrosis, and cell blocks demonstrated triphasic histology. In the remaining 2 cases, patients presented with localized disease and received a diagnosis on resection, with both patients demonstrating an epithelial-predominant morphology. Tumor cells in all cases were patchy variable positive for PAX8 and WT1 immunohistochemistry. Next-generation sequencing identified alterations previously reported in pediatric WT in 3 of 4 cases, including mutations in ASXL1 (2 of 4), WT1 (1 of 4), and the TERT promoter (1 of 4), as well as 1q gains (1 of 4); 1 case showed no alterations. Three patients were treated with pediatric chemotherapy protocols; during follow-up (range, 26-60 months), 1 patient died of disease. Conclusions.--WT is an unexpected and difficult entity to diagnose in adults and should be considered when faced with a primitive-appearing renal or metastatic tumor. Molecular testing may help exclude other possibilities but may not be sensitive or specific because of the relatively large number of driver mutations reported in WT. (Arch Pathol Lab Med. 2024;148:722-727; doi: 10.5858/arpa.2023-0127-OA), Wilms tumor (WT; ie, nephroblastoma), a commonly encountered diagnosis in the evaluation of pediatric renal tumors, is an exceedingly rare and challenging diagnosis in adult patients. (1) Patients with adult [...]

Author(s): Martina Hedenius [sup.1] [sup.2] , Irzam Hardiansyah [sup.2] , Terje Falck-Ytter [sup.2] [sup.3] [sup.4] Author Affiliations: (1) grid.8993.b, 0000 0004 1936 9457, Department of Public Health and Caring Sciences, [...]

Prior studies suggest autism-specific and general developmental screens are complementary for identifying both autism and developmental delay (DD). Parents completed autism and developmental screens before 18-month visits. Children with failed screens for autism (n = 167) and age, gender, and practice-matched children passing screens (n = 241) completed diagnostic evaluations for autism and developmental delay. When referral for autism and/or DD was considered, overall false positives from the autism screens were less frequent than for referral for autism alone. Presence of a failed communication subscale in the developmental screen was a red flag for autism and/or DD. An ordinally-scored autism screen had more favorable characteristics when considering autism and/or DD, yet none of the screens achieved recommended standards at 18 months, reinforcing the need for recurrent screening as autism emerges in early development., Author(s): Raymond Sturner [sup.1] [sup.2] , Paul Bergmann [sup.3] , Barbara Howard [sup.2] [sup.4] , Kerry Bet [sup.1] [sup.4] , Lydia Stewart-Artz [sup.1] , Shana Attar [sup.4] [sup.5] Author Affiliations: [...]

As the prevalence of developmental disorders (DDs) has increased, many OECD countries provide a national screening examination for early detection and intervention for DDs. This study examined effects of the National Health Screening Program in Korea. 65,334 children (39%) were DD-screened and 35,466 children (21%) received a false negative among the 167,050 study subjects. The DD-screened rate had increased from 3208 (27.2%) in 2008 to 8471 (47.3%) in 2012, then decreased to 5544 (29.8%) in 2017. Changes in the false negative rates increased from 2.7% in 2008 to 23.8% in 2017 were one of the most influential factors in these fluctuations. The DD-screened rate was influenced by demo-geographic and economic factors as well as by age-related characteristics of the subconditions., Author(s): Sung Sil Rah [sup.1] , Soon-Beom Hong [sup.2] , Ju Young Yoon [sup.3] Author Affiliations: (1) grid.31501.36, 0000 0004 0470 5905, College of Nursing, Seoul National University, , 103 [...]

In late 2019, a pneumonia of unknown etiology emerged in Wuhan, Hubei Province, China. In early 2020, public health officials identified the illness as coronavirus disease (COVID-19) and its causative [...]

This study examined the performance of the First Year Inventory (FYI; version 2.0), a community-normed parent-reported screening instrument, in a high-risk (HR) sample of 12-month-olds with older siblings diagnosed with autism spectrum disorder (ASD). The FYI 2.0 was completed by parents of 86 HR infants and 35 low-risk control infants at age 12 months, followed by clinical diagnosis at 36 months. HR infants later diagnosed with ASD had significantly higher FYI 2.0 risk scores in both the social-communication and sensory-regulatory domains than typically developing infants. New FYI 2.0 cutoff scores for HR sample were explored by evaluating various cutoff options after considering tradeoffs between sensitivity and specificity and sample characteristics., Author(s): Helen Y. Lee [sup.1] , Cheryl Vigen [sup.1] , Lonnie Zwaigenbaum [sup.5] , Susan Bryson [sup.3] , Isabel Smith [sup.3] , Jessica Brian [sup.4] , Linda R. Watson [sup.2] [...]

Background: Heightened risk of cardiovascular disease (CVD) and associated risk factors in people living with HIV (PLWH) have been reported in various settings; however, results are limited and differ geographically. [...]

There were nearly 12 million admissions to U.S. jails in 2011, the majority of them Black or Hispanic. We analyzed data on men's health screenings from the last Bureau of [...]

BACKGROUND: School-based screening for health conditions can help extend the reach of health services to underserved populations. Screening for mental health conditions is growing in acceptability, but evidence of cost-effectiveness is lacking. This study assessed costs and effectiveness associated with the Developmental Pathways Screening Program, in which students undergo universal classroom emotional health screening and those who have positive screens are provided with on-site clinical evaluation and referral. METHODS: Costs are enumerated for screening and clinical evaluation in terms of labor and overhead and summarized as cost per enrolled student, per positive screen, and per referral. Cost-effectiveness is summarized as cost per student successfully linked to services. School demographics are used to generate a predictive formula for estimating the proportion of students likely to screen positive in a particular school, which can be used to estimate program cost. RESULTS: Screening costs ranged from $8.88 to $13.64 per enrolled student, depending on the prevalence of positive screens in a school. Of students referred for services, 72% were linked to supportive services within 6 weeks. Cost-effectiveness was estimated to be $416.90 per successful linkage when 5% screened positive and $106.09 when 20% screened positive. A formula to estimate the proportion of students screening positive proved accurate to within 5%. CONCLUSION: Information concerning costs and effectiveness of school-based emotional health screening programs can guide school districts in making decisions concerning resource allocation. Keywords: emotional health; organization and administration of school health programs; child and adolescent health., INTRODUCTION Adolescent mental health conditions are prevalent and debilitating. (1) In the United States, as many as 21% of adolescents may be affected at any given time, with 65% experiencing [...]

The purpose of this article is to examine knowledge and health beliefs associated with cervical cancer screening among Korean American women. A telephone survey was conducted with 189 Korean American women in the Chicago area. Age, marital status, income, knowledge of early detection method for cervical cancer, and perceived beliefs about benefits of and barriers to receiving Pap tests were all related to outcomes of ever having a Pap test and having had one in the preceding 3 years. Variables uniquely related to ever having a Pap test were education, employment status, fluency in English, and proportion of life spent in the United States. Variables uniquely related to having had the test during the preceding 3 years were having a usual source of care and regular checkups. Different intervention components are suggested for the groups of Korean American women who have never had a Pap smear and for those who have not had one in the preceding 3 years, in addition to common intervention strategies that aim to increase knowledge and perceived benefit and to decrease perceived barriers to receiving Pap tests. Keywords: cervical cancer; screening behaviors; health behavior; symptom focus; Korean Americans; Pap smear; knowledge; beliefs

Objective: To assess the acceptability and face validity of a psychological assessment instrument, the Patient Health Questionnaire 9 (PHQ-9), as a depression screening tool for use with Aboriginal and Torres Strait Islander patients. Methods: Four focus groups were held in an urban, Aboriginal community-controlled health service. Participants' attitudes to screening for depression and the specific components of PHQ-9 were explored. Results: Process-oriented and PHQ-9-specific themes were raised. They included the role of family in the screening process, the need for a trusting relationship between the tool administrator and patient, the risk of confounding by social disadvantage or physical co-morbidities, the absence of a question assessing the presence of anger as a symptom of depression, and the importance of culturally appropriate language within the tool. Conclusion: Modification of the screening process and wording of the PHQ-9 in response to these concerns should render it acceptable for use with Aboriginal and Torres Strait Islander patients in this setting. Implications: These results may apply to the use of other psychological screening tools in the Aboriginal and Torres Strait Islander population. This is particularly relevant given the policy emphasis on screening in Indigenous health. Key words: Depression, culture, diagnosis, psychometrics.

Background. The study investigators conducted a vigorous screening protocol for delirium in rural long-term care (LTC) facilities for a period of 28 days focusing on Bioelectrical Impedance Analysis (BIA) and other hydration parameters as risk factors. Methods. A two-stage cluster sampling procedure was used to randomly select participants (n = 313) from 13 LTC facilities located in southeastern Iowa, stratified on facility bed size. BIA was used to estimate intracellular water (ICW), extracellular water (ECW), and total body water (TBW) on four occasions--baseline and follow-up days 7, 14, and 28. Volume estimates were calculated as a percent of body weight (%WT). Serum electrolytes and hematology were also measured. Delirium was measured with four strict criteria: a NEECHAM Confusion Scale score < 25, Vigilance 'A' score > 2, a Mini-Mental Status Examination < baseline, and a positive Confusion Assessment Method score. Results, There were n = 69 delirium cases (22.0%). Blood urea nitrogen/creatinine ratios greater than 21:1 (odds ratio = 1.76, 95% confidence interval 1.02-3.06). No significant risk for delirium was associated with ICW, ECW, or TBW as a percent of body weight. Conclusions. Some changes were observed with a slight decrease in ICW between day 7 and day 14 of follow-up that tended to follow an increase in delirium events, but in general the BIA measures did not predict delirium events.

Byline: P. Dargent-Molina (1), S. Piault (1), G. Breart (1) Keywords: Hip fracture; Osteodensitometry; Osteoporosis; Risk factors; Screening; Ultrasound Abstract: Decision to treat with an anti-osteoporotic drug should be based on individual fracture risk evaluation. We compared the discriminant value of four different screening strategies to identify elderly women with a risk of hip fracture greater than 20 per 1000 woman-years: (1) BMD screening alone, (2) quantitative ultrasound (QUS) screening alone, (3) QUS triage followed by BMD assessment for women with medium-low QUS parameters, and (4) selective BMD screening based on weight followed by clinical evaluation for women with medium-low BMD. The study population included 5910 women aged 75 years or older who participated to the EPIDOS (Epidemiologie de l'Osteoporose) prospective study. Over an average of 3.7 (+-0.8) years of follow-up, 231 women suffered a hip fracture, which corresponds to an average risk of 10.6 per 1000 woman-years. All strategies allow us to clearly distinguish a group at high risk of hip fracture (i.e. &gt 20 per 1000 woman-years) from a group at low risk (i.e. below the average risk in the cohort). QUS screening alone has a very low sensitivity (15%). The strategy using QUS as a method of triage and that combining selective BMD and clinical assessment have a sensitivity equivalent to systematic BMD screening (around 35%), with less than 50% BMD examinations. The high-risk women identified by these two strategies are not the same. A simple algorithm combining QUS, BMD, and clinical risk assessment allows an increased number of high-risk women to be identified (21%), and thus improves the sensitivity (53%). With this combined strategy, women in the high-risk group have one chance in ten of having a hip fracture over the next 4 years, whereas women in the low risk group have only one chance in 40. Author Affiliation: (1) INSERM (Institut National de la Sante et de la Recherche Medicale), 16 avenue Paul Vaillant-Couturier, Unite 149, 94 807, Villejuif Cedex, France Article History: Received Date: 27/03/2003 Accepted Date: 19/08/2003 Online Date: 30/09/2003 Article note: Members of the EPIDOS Study Group: Coordinators: G. Breart, P. Dargent-Molina(epidemiology), P.J. Meunier, A.M. Schott (clinical aspects), D. Hans (bone densitometry and ultrasound quality control), P.D. Delmas (biochemistry). Principal investigators (center): C. Baudoin, J.L. Sebert (Amiens) M.C. Chapuy, A.M. Schott (Lyon) F. Favier, C. Marcelli (Montpellier) E. Hausherr, C.J. Menkes, C. Cormier (Paris) H. Grandjean, C. Ribot (Toulouse)

POPULATION SCREENING FOR COLORECTAL DISEASE: A MUST DO? Colorectal cancer is the second commonest cause of cancer death in the Western world and the median five year survival from this [...]

Hereditary haemochromatosis (HH) is an inherited disorder of iron absorption. It meets several of the key public health principles for population-based screening and is considered to be a test-case for public health genetics. However, there has been relatively little debate in the public health or wider community regarding the merits of population-based genetic screening for HH. Genetic susceptibility to HH occurs in about 1:200 people and although mortality is low (age-standardised rate 2.75/million), there are potentially serious clinical manifestations of iron overload. Regular venesection is a simple and effective treatment for early stage iron overload. DNA-based testing is available and iron overload may be identified using serum transferrin saturation and ferritin tests. However, there are important gaps in knowledge relevant to screening for HH. The limited data on penetrance of HFE genotypes, and thus the uncertain probability that genetically susceptible individuals will develop clinically significant disease, is a major impediment to population-based genetic screening. Clinical evidence supports treating early-stage disease but no randomised controlled trials of the effectiveness of screening in reducing the burden of disease have been conducted. In addition, the natural history of early stages of HH and factors that may modify progression are unclear. Two international consensus panels on HH concluded that there is insufficient evidence for population-based screening at present. We present recommendations to advance the debate on screening for HH in Australia.

Oral cancer screenings can not only detect mouth cancer in people at high risk but can also educate them about the risk factors for mouth cancer. During a three-day oral screening program in New York and New Jersey, many of the 803 people screened knew that smoking was a risk factor for mouth cancer but they were unaware that alcohol use is also a risk factor.

This article discusses the usefulness of an effective screening protocol for an early detection of prostate cancer in men older than 50 with a >10-year life expectancy. Digital rectal examination combined with the measurement of serum prostate-specific antigen (PSA) levels and percent free PSA are reliable indicators of the prostate cancer.