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Biomedical subjects

V A Clark

Publications and source records attributed to V A Clark.

6 recordsLinked to original sources

Flexible sigmoidoscopy in asymptomatic patients with negative fecal occult blood tests.

BACKGROUND: Although the American Cancer Society and others have established guidelines for colorectal cancer screening, questions of who and how to screen still exist. METHODS: A 60-cm flexible sigmoidoscopy was performed on 1000 asymptomatic patients, 45 years of age or older, with negative fecal occult blood tests, who presented for routine physical examinations. Patients with clinically significant lesions were referred for colonoscopy. The proportion of lesions that would not have been found if the 24-cm rigid or the 30-cm flexible sigmoidoscope had been used was identified. RESULTS: Using the 60-cm flexible sigmoidoscope, lesions were found in 3.6% of the patients. Eighty percent of the significant lesions were beyond the reach of the 24-cm rigid sigmoidoscope and 37% were beyond the reach of the 30-cm sigmoidoscope. Thirty-six patients with lesions were referred for colonoscopy; additional lesions were found in 14%. A total of 62 lesions were discovered, including tubular adenomas, villous adenomas, tubular villous adenomas (23 of the adenomas with atypia), and one adenocarcinoma. The highest percentage of lesions discovered were in the sigmoid colon and the second highest percentage were in the ascending colon. CONCLUSIONS: The 60-cm flexible sigmoidoscope was able to detect more lesions than either the 24-cm or 30-cm sigmoidoscope when used in asymptomatic patients, 45 years of age and over, with negative fecal occult blood tests. When significant lesions are discovered by sigmoidoscopy, colonoscopy should be performed.

Adenocarcinoma

Nutrient estimates from computerized questionnaires vs. 24-hr. recall interviews.

A computerized nutritional assessment service used by dentists was investigated. Daily nutrient intake of forty-six adult subjects was estimated from replies to a computerized food frequency questionnaire and the results compared with the average nutrient intakes of the same individuals obtained during five 24-hr. dietary recall interviews. Although the two methods produced essentially the same mean for carbohydrate intake and a minimal difference in the mean caloric values, mean estimates of the other nutrients were 6 to 88 per cent greater with the computerized data than via the dietary recalls. The dietary assessment service included unwarranted recommendations for vitamin and mineral supplementation.

Adult

Rodney.

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Humans

Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent.

Low-income pregnant women of Mexican descent were studied to determine whether their food habits could be improved by nutrition education. Biochemical indices of nutritional status were also investigated. Twenty-four-hour dietary recalls were obtained at an initial interview and again at a final interview after a nutrition education program, which was offered to a randomly selected treatment group. At the initial interview, the mean nutrient intakes that were most often below two-thirds of the Recommended Dietary Allowance (RDA) were iron, vitamin A, thiamin, and calcium. The mean energy value of the diets was also frequently below the RDA. At the final intakes, although the mean energy values and the calcium and carbohydrate of both the control and treatment groups increased significantly, the following improvements in dietary intakes were seen only within the treatment group: 1) there were significant increases in the mean intake of protein, ascorbic acid, niacin, riboflavin, and thiamin, 2) there were significant decreases in the percentage of intakes below two-thirds of the RDA for ascorbic acid and riboflavin, and 3) there was a significant decrease in the incidence of multiple low nutrient intakes. These dietary improvements, which occurred only in the treatment group, suggest the effectiveness of the nutrition education program. The most common biochemical deficiencies were of folic acid, thiamin, and riboflavin. Except for an improvement in mean serum folate levels, the biochemical indices for the treatment group did not appear to be influenced by the nutrition education. It is possible that the vitamin and mineral supplements which were taken by 80% of the women could have obscured improvements in biochemical indices which may have been due to the education program.

Adult

Evaluation of a ghetto school breakfast program.

A program was initiated to provide a free breakfast at a ghetto elementary school. Community support was achieved at the expense of randomization of study subjects. While no significantly greater increase in school attendance or performance was detected in comparison with a control school, none of the students was malnourished and diets of students in the control school were as adequate as those in the breakfast school. Thus, it cannot be concluded that school breakfast programs would not benefit malnourished children or teen-agers who most often go without breakfast.

Black People