Early Diagnosis and Public Health and Ethics Issues

A special issue of Medicines (ISSN 2305-6320).

Deadline for manuscript submissions: closed (31 July 2021) | Viewed by 14622

Special Issue Editors


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Faculty of Medicine, Transilvania University of Brasov, 40268 Brasov, Romania
Interests: diagnostic and therapeutic biomarker investigation; laboratory medicine; novel clinical molecular diagnostic methods development
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Faculty of Medicine, Transilvania University of Brasov, Brasov, Romania
Interests: medicine; medical and health profession education; healthcare management; bioethics; history of science; telemedicine; rehabilitation
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear colleagues,

Public health authorities and international bodies are confronted with the need to diagnose the risk of disease early and to take prevention and treatment measures as quickly as possible, regardless of whether it is an infectious or non-infectious pathology; the use of current medicine and precision medicine for diagnosing diseases is not only an objective of specialists in different fields of curative medicine but also for those in public health.

The systematic approach of biomarkers can increase the accuracy of analyses, including in the case of population cohorts, the identification of risk factors, and, therefore, the implicitly of disease risk models, in parallel with the use of modern treatment methods, much cheaper and more accessible.

In this Special Issue, we invite manuscripts that address the correlation of current information, public health, and clinical research objectives with modern methods of diagnosis and treatment, and the systematization of information from the perspective of ethics and public health.

Original research papers, up-to-date, and critical reviews are welcome.

Please feel free to contact us and send us your suggestions that you would like to discuss beforehand. We look forward to and welcome your participation in this Special Issue.

Prof. Dr. Monica Florescu
Prof. Dr. Liliana Rogozea
Guest Editors

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Keywords

  • public health
  • ethics
  • diagnosis
  • clinical laboratory
  • precision medicine
  • treatment
  • rehabilitation medicine

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Published Papers (4 papers)

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16 pages, 1006 KiB  
Article
Prospective Comparison of 24-Hour Urine Creatinine Clearance with Estimated Glomerular Filtration Rates in Chronic Renal Disease Patients of African Descent
by Marlene Tapper, Donovan A. McGrowder, Lowell Dilworth and Adedamola Soyibo
Medicines 2021, 8(9), 48; https://doi.org/10.3390/medicines8090048 - 1 Sep 2021
Cited by 1 | Viewed by 3767
Abstract
Background: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet [...] Read more.
Background: The 24-hour (24-h) creatinine clearance (CrCl) is the most common method for measuring GFR in clinical laboratories. However, the limitations of CrCl have resulted in the widespread acceptance of mathematically derived estimated glomerular filtration rate (eGFR) using Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations in predicting eGFR. The aim of the study was to compare 24-h CrCl with eGFR derived from these formulae and to identify which could be the best alternative. Method: A prospective study was conducted involving 140 CKD patients. Creatinine and cystatin C concentrations were determined using the cobas 6000 analyzer. The eGFR was calculated using the CG formula, 4-variable MDRD and CKD-EPI equations, and Bland-Alman plots bias was determined. Results: The CG and MDRD formulas had mean eGFR values similar to CrCl and correlation coefficients (r) were highest for CG (0.906) and lowest for MDRD (0.799). The CG equation was in agreement with 24-h CrCl in all but stage V CKD while the MDRD equation compared well in all except Stage IV CKD. The CG equation was positively biased (0.9857) while the MDRD had a negative bias (−0.05). Conclusion: The Cockcroft-Gault formula provides a more accurate assessment of GFR than 24-h CrCl and would be recommended as a substitute to provide the best estimate of GFR in our population. Full article
(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)
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9 pages, 1039 KiB  
Article
Clinical Significance of Gamma-Glutamyltranspeptidase Combined with Carbohydrate-Deficient Transferrin for the Assessment of Excessive Alcohol Consumption in Patients with Alcoholic Cirrhosis
by Akihiko Shibamoto, Tadashi Namisaki, Junya Suzuki, Takahiro Kubo, Satoshi Iwai, Fumimasa Tomooka, Soichi Takeda, Yuki Fujimoto, Masahide Enomoto, Koji Murata, Takashi Inoue, Koji Ishida, Hiroyuki Ogawa, Hirotetsu Takagi, Daisuke Kaya, Yuki Tsuji, Takahiro Ozutsumi, Yukihisa Fujinaga, Masanori Furukawa, Norihisa Nishimura, Yasuhiko Sawada, Koh Kitagawa, Shinya Sato, Hiroaki Takaya, Kosuke Kaji, Naotaka Shimozato, Hideto Kawaratani, Kei Moriya, Takemi Akahane, Akira Mitoro and Hitoshi Yoshijiadd Show full author list remove Hide full author list
Medicines 2021, 8(7), 39; https://doi.org/10.3390/medicines8070039 - 19 Jul 2021
Cited by 3 | Viewed by 3394
Abstract
Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers [...] Read more.
Background: This study aimed to compare the diagnostic performance of carbohydrate-deficient transferrin (CDT) and gamma-glutamyltranspeptidase (γ-GTP) to assess the single and combined benefits of these biological markers for the detection of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Methods: Biological markers were determined in blood samples from patients with alcoholic cirrhosis (drinking group, n = 35; nondrinking group, n = 81). The prediction accuracy of %CDT alone, γ-GTP alone, and their combination for the detection of excessive alcohol consumption was determined in patients with alcoholic cirrhosis. Results: Serum total bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-GTP, and alkaline phosphatase levels and %CDT were significantly higher and serum albumin levels were significantly lower in the drinking group than in the nondrinking group. The combination of %CDT and γ-GTP compared with %CDT or γ-GTP alone showed a higher prediction accuracy. The combination of %CDT and γ-GTP exhibited a higher specificity than γ-GTP alone. However, in terms of sensitivity, no significant difference was found between single or combined markers. Conclusions: The combination of %CDT and γ-GTP is considered a useful biomarker of chronic excessive alcohol consumption in patients with alcoholic cirrhosis. Full article
(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)
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11 pages, 461 KiB  
Article
Creation of a New Frailty Scale in Primary Care: The Zulfiqar Frailty Scale (ZFS)
by Abrar-Ahmad Zulfiqar
Medicines 2021, 8(4), 19; https://doi.org/10.3390/medicines8040019 - 13 Apr 2021
Cited by 7 | Viewed by 3884
Abstract
Introduction: Very few frailty scales are used by general practitioners as they are time consuming and cumbersome. We designed a new scale for the rapid detection of frailty. Methods: We developed a frailty screening tool for use in primary care, referred to as [...] Read more.
Introduction: Very few frailty scales are used by general practitioners as they are time consuming and cumbersome. We designed a new scale for the rapid detection of frailty. Methods: We developed a frailty screening tool for use in primary care, referred to as the Zulfiqar Frailty Scale (ZFS). This scale was tested in a general practitioner’s office for six months in Plancoët, France. Only patients over 75 years of age with Activities of Daily Living (ADL) ≥4 were included. The objective of this research was to validate the scale, evaluate its performance, and compare this screening tool with other scales such as the Fried Scale, the Gerontopole Frailty Screening Tool (GFST), the modified Short Emergency Geriatric Assessment (mSEGA) Grid A, and the Comprehensive Geriatric Assessment (CGA). Results: A total of 102 patients were included, with a mean age of 82.65 ± 4.79; 55 were women and 47 were men. The percentage of frail subjects was 63.7% in our scale, 67.7% in the mSEGA grid A, 75.5% in the GFST, and 60.8% for the Fried criteria. After a comprehensive geriatric assessment, frailty syndrome was found in 57 patients (55.9%). In general, both scales showed solid performance, and differences between them in the sample were minimal. As the CGA showed a prevalence of frailty of 55.9%, a similar prevalence threshold for the ZFS (i.e., 64% at the threshold ≥3 could be assessed). The completion time for our scale was less than two minutes, and staff required no training beforehand. Its sensitivity was 83.9%, and its specificity was 67.5%. Its positive predictive value was 80%, and its negative predictive value was 73%. The Pearson correlations between the geriatric scores were all strong and roughly equivalent to each other. Conclusions: Our frailty screening scale is simple, relevant, and rapid (taking less than two minutes). Full article
(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)
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8 pages, 582 KiB  
Brief Report
Frailty in Primary Care: Validation of the simplified Zulfiqar Frailty Scale (sZFS)
by Abrar-Ahmad Zulfiqar
Medicines 2021, 8(9), 51; https://doi.org/10.3390/medicines8090051 - 3 Sep 2021
Cited by 3 | Viewed by 2474
Abstract
Introduction: Frailty scales are used very rarely by general practitioners as they are time consuming and are not well-adapted to current needs. Thus, we have designed with general practitioners a new scale for the early and rapid detection of frailty syndrome, called the [...] Read more.
Introduction: Frailty scales are used very rarely by general practitioners as they are time consuming and are not well-adapted to current needs. Thus, we have designed with general practitioners a new scale for the early and rapid detection of frailty syndrome, called the simplified Zulfiqar Frailty Scale (sZFS). Patients and methods: This scale was tested in two general medicine practices in Normandy (France) for a total of six months and compared to the GFST tool “The Gerontopole Frailty Screening Tool”. Only patients who were over 65 years old with an ADL ≥ 4/6 were included. Results: 107 were patients included in the general medicine practice, with an average age of 74 years. The sZFS questionnaire has a shorter administration time than the GFST questionnaire (p < 0.001). Its sensitivity is of 93%, and its specificity is 58%. Its positive predictive value is 57%, and its negative predictive value is 93%. The area under the curve of the sZFS scale is 0.83 [0.76; 0.91] (IC95%). Conclusion: Our frailty screening scale is simple, relevant, and quick. Full article
(This article belongs to the Special Issue Early Diagnosis and Public Health and Ethics Issues)
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