ROMA index
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Cíl studie: Sledování a vyhodnocení přínosu výpočtu ROMA indexů u ovarialního karcinomu a porovnání s hodnotami sérových nádorových markerů HE4 a CA125. Typ studie: Prospektivní studie Materiál a metody: V období od června 2010 do prosince 2011 bylo v Imunoanalytické laboratoři FN Plzeň vyšetřeno sérum 553 pacientek gynekologicko-porodnické kliniky. Pacientky byly rozděleny do skupin podle diagnóz (benigní, maligní) a dále pak do dalších dvou skupin podle menopauzálního statusu. Hodnoceny byly tedy celkem čtyři skupiny. U všech pacientek bylo stanoveno HE4 a CA125 chemiluminiscenční metodou na přístroji Architect i1000 (Abbott, USA). Dále byly vypočítány ROMA indexy a jejich hodnoty porovnány se sérovými hodnotami HE4 a CA125. Pro veškeré další statistické výpočty byl použit statistický software SAS 9.2. Výsledky: ROMA indexy, HE4 a CA125 byly významně zvýšeny ve skupině premenopauzálních i postmenopauzálních pacientek s histologicky potvrzeným karcinomem ovarií oproti skupinám s benigním tumorem ovarií. Pro diferenciální diagnostiku benigních a maligních nádorů ovarií je možné použít ROMA indexy, HE4 a CA125 (shodně p-Value <0,0001). Podle hodnot AUC jsme sestavili pořadí užitečnosti jednotlivých parametrů v premenopauzálním a postmenopauzálním období. Nejvyšší přínos měl v našem souboru žen výpočet ROMA2 indexu, který se kalkuluje v postmenopuzálním období (AUC=0,9777), následuje pak CA125 postmenopauzálně (AUC=0.9715) a CA125 premenopauzálně (AUC=0,9534). Nejnižší výtěžnost měl HE4 premenopauzálně (AUC=0,8702). Závěr: Hodnoty ROMA1 indexu, ROMA2 indexu, HE4 a CA125 byly významně zvýšené ve skupinách ovariálních karcinomů oproti skupinám benigních nádorů ovarií. Výše uvedené parametry lze tudíž použít pro diferenciální diagnostiku ovariálního karcinomu. Pokud bychom měli hovořit o možném využití při prvozáchytu karcinomu ovarií, v našem souboru se jevil nejlépe ROMA2 index. ROMA1 index nedosáhl takové efektivity. Z hodnot AUC je možné dále vysledovat, že HE4 nedosáhl tak dobrých výsledků jako CA125. Jejich vzájemná kombinace a vypočet zejména ROMA2 indexu však ukazuje na oprávněnost zařazení HE4 do rutinního klinického využití.
Objective: Monitoring and evaluation of the benefit of ROMA indexes calculation in ovarian cancer and comparison with values of serum tumor markers HE4 and CA125 Design: Prospective study Material and Methods: In the period from June 2010 to December 2011 was in the Immunoanalytical laboratory, University Hospital Pilsen serum of 553 patients from department of Gynecology and Obstetrics examined. Patients were divided into groups by diagnosis (benign, malignant) and then into the other two groups according to menopausal status. Total of four groups were evaluated. For all patients HE4 and CA125 were determined using the chemiluminescent Architect i1000 instrument (Abbott, USA). In addition, ROMA indexes were calculated. In the next step ROMA values were compared with the serum HE4 and CA125 values. Statistical software SAS 9.2 was used for all other statistical calculations. Results: ROMA indexes, HE4 and CA125 were significantly increased in the group of premenopausal and postmenopausal patients with histologically confirmed ovarian cancer compared with groups of benign ovarian tumors. For differential diagnosis of benign and malignant ovarian tumors can be used ROMA indexes, HE4 and CA125 (both p-value <0.0001). According to the AUC, we compiled a ranking usefulness of the various parameters in pre-menopausal and postmenopausal period. The highest contribution had in our group of women the calculation of ROMA2 index that is calculated in postmenopusal period (AUC = 0.9777), followed by the CA125 postmenopausal (AUC = 0.9715) and CA125 premenopausal (AUC = 0.9534). The lowest yield was HE4 premenopausal (AUC = 0.8702). Conclusion: Values of ROMA1 index, ROMA2 index, HE4 and CA125 were significantly increased in groups of ovarian cancer compared with benign ovarian tumors groups. All the parameters can be used for differential diagnosis of ovarian cancer. If we were talking about a possible use in primary detection of ovarian cancer ROMA2 index was the best one. ROMA1 index did not reach such efficiency. According AUC can be observed that HE4 didn‘t achieve such good results as CA125. Their combination, and especially ROMA2 index calculation shows the permissibility of HE4 inclusion into routine clinical practice.
- MeSH
- algoritmy MeSH
- antigen CA-125 * analýza MeSH
- diferenciální diagnóza * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery analýza MeSH
- nádory vaječníků * diagnóza MeSH
- postmenopauza MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- práce podpořená grantem MeSH
AIM: The first aim of the project was to evaluate the benefits of the determination of human epididymis protein 4 (HE4) and the risk of ovarian malignancy algorithm (ROMA) index for primary detection of ovarian cancer in a population of Czech women. The second aim was to study the advantages HE4, cancer antigen 125 (CA125) and ROMA index for distinguishing between benign and malignant tumors. Aware of the age distribution of ovarian cancer, we focused on postmenopausal patients. PATIENTS AND METHODS: Our group of patients consisted of 256 females, 21 with ovarian cancer and 235 with benign ovarian tumors. All diagnoses were histologically verified. We determined the serum levels of HE4 and CA125 and calculated the ROMA2 index for postmenopausal women. Serum levels of the analytes were measured using an Architect 1000i instrument. Serum samples were collected prior to surgery or any other form of treatment and the results of the two groups of patients were compared (malignant vs. benign). RESULTS: There was a significant difference in the serum levels for all parameters studied between the groups of patients with malignant and those with benign diagnoses (Wilcoxon test, p<0.0001). When all parameters were evaluated at 95% specificity, the HE4 cut-off was 112 pmol/l at a sensitivity of 71.42%, a positive predictive value (PPV) of 55.56%, a negative predictive value (NPV) of 97.14% and an area under the curve (AUC) of 0.9152. The CA125 cut-off was 81 IU/l at a sensitivity of 80.95%, a PPV of 58.62%, a NPV of 98.23% and an AUC of 0.9731. ROMA2 index had a cut-off 37.70% at a sensitivity of 85.71%, a PPV of 62.06%, a NPV of 98.65% and an AUC of 0.9803. The highest diagnostic efficiency was achieved by the ROMA2 index. CONCLUSION: Determination of HE4 along with CA125 and ROMA2 index calculation is a suitable method for the improvement of the primary detection of ovarian cancer. This approach also improves the differential diagnostic possibilities for distinguishing between malignant and benign tumors.
- MeSH
- algoritmy MeSH
- antigen CA-125 krev MeSH
- lidé středního věku MeSH
- lidé MeSH
- membránové proteiny krev MeSH
- nádory vaječníků krev MeSH
- nemoci ovaria krev MeSH
- postmenopauza krev MeSH
- proteiny metabolismus MeSH
- věkové faktory MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Tuberculosis (TB) contact tracing and TB preventive treatment are key tools in preventing the transmission of TB with the aim of eliminating the disease. Our study seeks to demonstrate how the infection spread from an individual patient to the entire community and how proactive contact tracing facilitated prompt diagnosis and treatment. Our work was conducted as a retrospective analysis of the spread of TB infection within the Roma community in the Czech Republic, following the case of an index patient who succumbed to pulmonary TB. Several levels of care and preventive and treatment measures are outlined. Confirming the identity of the Mycobacterium tuberculosis strain was achieved using molecular methods. Among the 39 individuals examined, TB disease was detected in eight patients and TB infection was detected in six patients. The investigation of contacts within this group yielded positive results in 36% of cases, necessitating treatment. The study's findings provide evidence that actively tracing individuals at risk can lead to early detection of cases, prompt treatment, and prevention of further disease transmission. The study also indicates that the highest risk of infection occurs within the sick person's household and that young children under the age of 5 are most susceptible to falling ill.
- MeSH
- latentní tuberkulóza * MeSH
- lidé MeSH
- plicní tuberkulóza * epidemiologie MeSH
- předškolní dítě MeSH
- retrospektivní studie MeSH
- Romové * MeSH
- trasování kontaktů metody MeSH
- tuberkulóza * diagnóza epidemiologie MeSH
- Check Tag
- lidé MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
^^^sv. : il.
OBJECTIVE: At present, health characteristics of Roma minority within the Czech Republic are generally unknown. Therefore we examined a Roma population for some anthropometrical, biochemical and genetic parameters. DESIGN: Groups include Roma aged above 18 years (men, women), with permanent residence in the South Bohemia Region. The Roma group (302 individuals) was selected using the snowball sampling method--the same method was used to select the non-Roma control group (78 individuals) for total cholesterol and blood sugar reference values. The main non-Roma control group was selected using the quota selection method (298 individuals). All participants completed a life style questionnaire, had their body measurements taken, were weighed, had their blood pressure and heart rates measured, had a capillary blood sample taken. RESULTS: The non-Roma population had a lower Body Mass Index (BMI) (25.86 ± 4.23 vs. 27.45 ± 6.48 kg/m², p = 0.0004). The difference in BMI and weight was found to be associated with the MC4R gene. The values of systolic and diastolic blood pressure, total cholesterol, blood sugar did not differ with regard to the tested polymorphisms. We did not find any difference in the prevalence of MC4R or TMEM18 between groups. CONCLUSION: Despite educational efforts to introduce healthier life styles into the Roma population, there has been only limited success; as a result, Roma are very likely to suffer from premature complications of atherosclerotic processes, mostly due to theirs life style. Intensive further research is needed to improve the health conditions of the Roma minority, while still respecting their cultural differences.
- MeSH
- dospělí MeSH
- index tělesné hmotnosti * MeSH
- kardiovaskulární nemoci etnologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- menšiny MeSH
- Romové etnologie genetika MeSH
- životní styl etnologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Nadváha a obezita patří k onemocněním, jejichž výskyt v celosvětovém měřítku neustále stoupá. Mají dopad na všechny stránky lidského života, ale i zdravotní péči a její finanční náročnost. Jejich prevence se proto stala významným bodem strategií zaměřených na zlepšení zdravotního stavu populace. Pro zajištění efektivity těchto strategií je však nutné zmapování determinant (vč. faktoru etnicity), které mohou vznik nadváhy a obezity ovlivňovat. V České republice patří k nejpočetnějším minoritám Romové. Předkládaný příspěvek je proto zaměřen na nastínění vybraných jídelních zvyklostí právě u této minority, zejména pak příjmu ovoce a zeleniny, sladkého pečiva, sladkostí a tradičních romských jídel. Ve sledovaném souboru bylo zastoupeno celkem 600 respondentů, z nichž 302 bylo z romské minority a 298 z většinové populace. Z výsledků vyplývá výrazně nižší míra konzumace ovoce a zeleniny u romské minority oproti většinové populaci. Zároveň byla u Romů potvrzena vyšší míra konzumace sladkého pečiva a četnější konzumace sladkostí. V kontextu k dalším ovlivnitelným faktorům přispívají výsledky sledování k pochopení kulturních vzorců lidského chování, jejichž začlenění do preventivních programů může napomoci zvýšení jejich efektivnosti.
Overweight and obesity belong to diseases which incidence is increasing worldwide. They have an impact on all aspects of human life and on health care and financial demands too. Therefore, their prevention has become an important point of strategies aimed at improving the health status of a population. To ensure the effectiveness of these strategies it is necessary to map the determinants (incl. the factor of ethnicity) that might influence incidence of overweight and obesity. In the Czech Republic, the Roma minority belongs to the most numerous ones. Therefore, the aim of this paper is to outline selected eating habits of this minority, especially the intake of fruit and vegetables, pastries, sweets and traditional Roma dishes. A total of 600 respondents were in the sample, 302 from the Roma minority and 298 from the majority population. The results showed a significantly lower rate of consumption of fruit and vegetables among the Roma minority compared to the majority population. Analysis confirmed a higher rate of consumption of pastries and more frequent consumption of sweets in Roma minority. In the context of other modifiable factors the results contribute to the understanding of cultural patterns of human behaviour and their inclusion into prevention programs can help to increase their efficiency.
- MeSH
- cukrovinky MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- nadváha diagnóza epidemiologie MeSH
- obezita diagnóza epidemiologie MeSH
- ovoce MeSH
- preference v jídle * MeSH
- Romové * MeSH
- rozhovory jako téma MeSH
- stravovací zvyklosti * MeSH
- zdravé chování MeSH
- zelenina MeSH
- zvyky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
OBJECTIVES: The objective of our correlation study was to compare selected indicators of overweight and obesity of Roma and non-Roma (majority) populations in the South Bohemia Region or the Czech Republic. METHODS: The following indicators were chosen for evaluation of overweight and obesity: body height and weight, waistline measurement, waist/height index, waist/hips index, BMI, total fat and blood pressure. 600 participants were examined and interviewed in total, including 302 Roma and 298 non-Roma participants. Each of the participants had a personal examination performed by a general nurse, under hygienic-epidemiological conditions. The criteria for inclusion of participants into the study were consent with examination and age greater than 18 years. RESULTS: The statistical analysis showed that, at a level of significance of p < 0.001, the following values differed between the Roma and non-Roma population of the South Bohemia Region: waist/height index, waistline, total fat, body mass index (BMI), systolic and diastolic blood pressure. Differences in the incidence of the waist/hips index were significant at p < 0.01. Correlations of incidence with indicators of overweight and obesity in Roma were registered in relation to both age and gender of participants. The results show that overweight and obesity indicators were recorded more frequently in Roma female respondents. Although the results are unique, the conclusions cannot be generalized for Roma throughout the Czech Republic. CONCLUSION: The conclusions of the above findings will be implemented in strategic materials for community planning in the South Bohemia Region. The goal will be to offer services aimed at supporting a healthy life style for Roma living in the South Bohemia Region of the Czech Republic.
- MeSH
- dospělí MeSH
- index tělesné hmotnosti * MeSH
- krevní tlak fyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nadváha etnologie MeSH
- obezita etnologie MeSH
- obvod pasu fyziologie MeSH
- Romové etnologie MeSH
- sexuální faktory MeSH
- tuková tkáň fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
BACKGROUND: Obesity-induced metabolic syndrome is a multiple risk factor for cardiovascular (CV) risk factors and type 2 diabetes, and ethnic minorities seem to have unfavourable medical risk factors in general more frequently than majority populations. OBJECTIVE: The aim of this study was to evaluate the prevalence of cardiovascular risk factors in relation to metabolic syndrome in the Roma population compared with the non-Roma population residing in the eastern part of Slovakia. RESULTS: 123 Roma and 79 non-Roma patients with metabolic syndrome were evaluated. Men between 40-55 years of age had 4.76-times higher odds and women 5.26-times higher odds for metabolic sydrome compared with the younger population. We found statistically significant higher waist circumference in the Roma subpopulation and higher body mass index as well, although in selected population with metabolic syndrome. HDL cholesterol was significantly lower in both Roma men and women, and LDL cholesterol was not significant in men and women with metabolic syndrome. Triglycerides levels were significantly higher in non-Roma women only. High-sensitivity C-reactive protein (hsCRP) values were not in correlation with age but were associated with the increasing number of fulfilled criteria for metabolic syndrome in both subgroups (Roma, non-Roma), independently of gender. CONCLUSION: Our study confirmed higher prevalence of obesity, metabolic syndrome and other CV risk factors associated with metabolic syndrome among younger Roma population, which may be associated with increased cardiovascular disease (CVD) morbidity and mortality among elderly Roma compared with non-Roma.
- MeSH
- charakteristiky bydlení statistika a číselné údaje MeSH
- dospělí MeSH
- dyslipidemie etnologie MeSH
- index tělesné hmotnosti MeSH
- kardiovaskulární nemoci etnologie MeSH
- komorbidita MeSH
- lidé středního věku MeSH
- lidé MeSH
- metabolický syndrom etnologie MeSH
- mladiství MeSH
- mladý dospělý MeSH
- prevalence MeSH
- rizikové faktory MeSH
- Romové etnologie statistika a číselné údaje MeSH
- rozložení podle pohlaví MeSH
- věkové rozložení MeSH
- venkovské obyvatelstvo statistika a číselné údaje MeSH
- zánět etnologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- Geografické názvy
- Slovenská republika MeSH
OBJECTIVE: To compare the Copenhagen Index (CPH-I) and the Risk of Ovarian Malignancy Algorithm (ROMA) in the differential diagnosis of ovarian tumors. METHODS: In a retrospective study, data were reviewed from women with ovarian tumors who attended University Hospital Brno, Czech Republic, between July 2011 and June 2015. The women were classified into the benign tumor group or malignant tumor group (borderline and malignant tumors). Serum levels of CA125 and HE4 were extracted from medical records. The two tumor indices were calculated using relevant clinical data. RESULTS: Among 267 included women, 110 had benign tumors, 42 had borderline ovarian tumors, and 115 had malignant tumors. The two indices showed similar discriminatory performance with no significant differences (P>0.05). In the differentiation of benign tumors from all stages of borderline tumor and ovarian cancer, ROMA showed a sensitivity of 71% at a specificity of 88%, whereas CPH-I showed a sensitivity of 69% at a specificity of 85%. CONCLUSION: CPH-I is a potential tumor index that is independent of menopausal status. It might be applied as a simple alternative to ROMA in settings of basic medical care.
- MeSH
- algoritmy * MeSH
- antigen CA-125 krev MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádorové biomarkery krev MeSH
- nádory vaječníků krev klasifikace diagnóza patologie MeSH
- retrospektivní studie MeSH
- riziko MeSH
- senioři MeSH
- senzitivita a specificita MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- srovnávací studie MeSH
- Geografické názvy
- Česká republika MeSH