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At least 217 records · Page 12Linked to original sources
PubMed2006

Navy Asbestos Medical Surveillance Program 1990-1999: demographic features and trends in abnormal radiographic findings.

A 10-year cross-sectional analysis was conducted for 233,353 radiographic examinations performed as part of the Navy Asbestos Medical Surveillance Program. Demographic and temporal trends in abnormal radiographs were assessed during this analysis. Abnormal radiograph prevalence increased significantly with age, and abnormal radiographs were nearly 30 times more likely to occur among participants 60 to 69 years of age, compared with participants < 20 years of age (odds ratio, 27.57; 95% confidence interval, 14.75-51.53). Men were 5 times more likely than women to have an abnormal radiograph (odds ratio, 5.84; 95% confidence interval, 5.02-6.80); after controlling for differences in age, this gender association remained significant only for participants > 30 years of age. The proportion of abnormal radiographs decreased significantly over the study period [chi2 (df = 1) test for trend, chi2 = 198.7, p < 0.0001], although the cohort mean age increased. Despite aging of the Asbestos Medical Surveillance Program population, the overall prevalence of radiographic abnormalities is declining; future studies should examine the reasons for this observation.

Adolescent↗
PubMedDate not supplied

[The educating and informing of the population on HIV/AIDS problems in the Republic of Byelarus].

Data on the spread of knowledge and information among the population of the Republic of Belarus, mainly young people aged 14-20 years as the most susceptible group, are presented. Sociological questioning carried out among students of institutions of higher education indicated that 91% of them did not admit the possibility of getting HIV infection; the majority of students of technical and high schools denied the role of casual sexual relations in the spread of HIV infection. The questioning revealed that the main source of information was television for 83.5% of the questioned students, newspapers and magazines for 82.9% and radio for 35%. The sociological study made it possible to lay special emphasis on educational institutions in the work on the information and education of the population. Programs, recommendations and other information materials on the problem of the prophylaxis of HIV/AIDS were developed. Information is provided in educational institutions during classes and non-class work. Institutions of culture also play their due role in providing better information to young people. The Centre issued 26 video reels, 2 films and 3 audio reels.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communities.

OBJECTIVE: Our goal was to compare the quality of diabetic care received by patients in rural and urban communities. STUDY DESIGN: We performed a retrospective analysis of claims data captured by the Medicare program. POPULATION: We included all fee-for-service Medicare patients 65 years and older living in the state of Washington who had 2 or more physician encounters for diabetes care during 1994. OUTCOME MEASURES: The outcomes were the extent to which patients received 3 specific recommended services: glycated hemoglobin determination, cholesterol measurement, and eye examination. RESULTS: A total of 30,589 Medicare patients (8.4%) were considered to have diabetes; 29.1% lived in rural communities. Generalists provided most diabetic care in all locations. Patients living in small rural towns received almost half their outpatient care in larger communities. Patients living in large rural towns remote from metropolitan areas were more likely to have received the recommended tests than patients in all other groups. Patients who saw an endocrinologist at least once during the year were more likely to have received the recommended tests. CONCLUSIONS: Large rural towns may provide the best conditions for high-quality care: They are vibrant, rapidly growing communities that serve as regional referral centers and have an adequate-but not excessive-supply of both generalist and specialist physicians. Generalists provide most diabetic care in all settings, and consultation with an endocrinologist may improve adherence to guidelines.

Aged↗
PubMedDate not supplied

Transmission of leprosy within households.

As part of the leprosy control program, population follow-up studies were carried out during 1962 to 1970 in Gudiyatham Taluk, an administrative unit in South India (population: 400,000). More than 97% of the 23,285 contacts from 5,088 families having a leprosy patient were clinically examined using accepted methodology and confirmed as having or not having leprosy. New cases developing among household contacts of leprosy (secondary attack rates) were determined and studied in relation to characteristics of the index case and that of contacts. The secondary attack rate is defined as the number of new cases discovered in the contacts of leprosy patients per 1,000 person-years, which is equivalent to observing 1,000 persons per year. Nearly two-thirds of all new cases were of the tuberculoid type of leprosy and another one-sixth of indeterminate type. Lepromatous and borderline cases each constituted about ten percent of the total new cases. The total secondary attack rate was 6.8 per 1,000 person-years. Compared to an annual incidence rate of 0.8 per 1,000 in the total population, this incidence rate among the contacts is nearly ten times higher. Such enhanced risks are observed clearly and consistently when studied by the number of patients within a family for both sexes and in various age-groups. The rate for females (6.3 per 1,000 person-year) though less, was not significantly different from that of males (7.1 per 1,000 person-year). The differences observed between males and females for each type of leprosy were also not statistically significant. The risks for children (less than 15 years) are significantly higher than those for adults. Among boys, the maximum risk was observed in the age-group 5-14 years, whereas for females the risk is highest in the age-group 5-9 years, dropping down significantly after that. Furthermore, it was observed that significant differences existed between children and adults only in males but not in females. The secondary attack rates almost doubled when there were multiple index cases in the family. Regardless of the number of index cases, the male-female differences were not statistically significant. Attack rates were significantly enhanced when there was a bacilliferous type of leprosy (lepromatous or borderline) in the family. This was true for the specific attack rates of each type of leprosy too. However, a significantly higher proportion of lepromatous and borderline types is also seen when there is a bacilliferous type of leprosy present. The study reiterates the differences in susceptibility to leprosy among males and females, especially during younger ages. Further immunological studies are necessary to determine the differences in host responses in males and females that produce such a characteristic sex-ratio in prevalence of leprosy. There is still a great need to obtain more data on incidence rates both in general population and among contacts on the basis of prospective observation using acceptable statistical technics in design and analysis.

Adolescent↗
PubMedDate not supplied

Relation between aryl hydrocarbon hydroxylase inducibility, serum gamma-glutamyltransferase and serum cholesterol in middle-aged smokers and non-smokers.

Aryl hydrocarbon hydroxylase (AHH) inducibility, carbon monoxide in expired air (CO), serum gammaglutamyl-transferase (GGT), and total cholesterol were compared in equal-sized, age-matched samples of healthy middle-aged males born in 1921, 1934-1936, and 1946 attending the ongoing preventive medical population program in Malmö. AHH did not differ in various age - and smoking or non-smoking groups, and there were no correlations between AHH, GGT, and cholesterol. The findings provide evidence against the recent hypothesis that low cholesterol may mediate or reflect a carcinogenic mechanism through a state of general enzyme induction in the body.

Aryl Hydrocarbon Hydroxylases↗
PubMed1985

A risk factor approach to the alcohol-related diseases.

Alcohol-related disorders belong to the spectrum of major non-infectious diseases in Western societies which are capable of prevention by means that have not yet been fully implemented. The mortality in a population of 10,353 middle-aged males invited to a preventive medical population program in Malmö was assessed for 1.5-6.5 years (mean 4.5 years) after the time of invitation and analysed in relation to participation or non-participation. The characteristics at entry of the 7948 males who participated in screening were compared in order to evaluate risk factor patterns for the major categories of premature death during the follow-up period. Among the non-participants for screening the mortality rate was twice as high, and the death rate due to alcohol-related diseases was five times higher than among the participants. There were no significant differences between participants and non-participants in the other death causes. The autopsy rate was high, at 87.8%. Even in the males participating in the screening, alcohol-related deaths constituted a major mortality category, comprising 55 of 218 cases, whereas cancer comprised 61 and coronary heart disease 50 of the premature deaths in this group. In these three main categories of male premature mortality, significant and distinctly differential risk factor patterns were found. Risk factors for coronary heart disease involved smoking, serum cholesterol, triglycerides and systolic blood pressure, and for alcohol-related deaths involved gamma-glutamyltransferase, an alcoholism screening questionnaire and, inversely, serum cholesterol and serum creatinine. In both groups of diseases, these risk factors could be combined into a highly predictive multiple logistic risk factor function. The discriminative power of this instrument was higher for the alcohol-related deaths than for the coronary heart disease deaths. Malignant and alcohol-related diseases constituted at least equally prominent categories as the cardiovascular disorders among the deaths that occurred within middle age in these cohorts. All of these conditions are potentially avoidable and are associated with significant and distinctive risk factor patterns. Risk factors may be applied to the alcohol-related disorders as signals for preventive measures in analogy with tested methods for the regulation of blood pressure and serum lipids.

Alcoholism↗
PubMed1988

Molecular basis and prenatal diagnosis of beta-thalassemia.

The molecular characterization of mutations producing beta-thalassemia in world populations is nearing completion. We expect that new rare alleles in thoroughly studied groups and other alleles in less studied groups, eg, inhabitants of New Guinea, Latin America, and certain Pacific Islands, will be found. Knowledge of the molecular basis of the disease and new technology that allows rapid detection of single nucleotide changes in genomic DNA have led to the reality of prenatal diagnosis by direct mutation detection even in the heterogeneous US population. Programs aimed at prevention of beta-thalassemia should be facilitated by these developments.

Humans↗
PubMed1988

A cost-based decision analysis for Chlamydia screening in California family planning clinics.

Antibody-based methods for the diagnosis of Chlamydia trachomatis infection of the cervix have recently made population screening programs possible for this epidemic and frequently asymptomatic problem. We constructed a decision model, using medical care costs as utilities, to determine the total costs of screening and of not screening in California state-funded family planning clinics, and to determine the prevalence of infection at which such screening could be expected to pay for itself. A net savings of $6 million would be realized in the first year, with annual savings eventually increasing to over $13 million, from the prevention of chlamydia-associated pelvic inflammatory disease and other long-term sequelae such as tubal infertility and ectopic pregnancy. Over $60 million could be saved in the first five years of such a statewide screening program. In populations with infection prevalence of 2% or more, such screening will pay for itself and can be considered "cost-effective." Screening of asymptomatic women for chlamydia should be carried out in most American family planning clinics.

Chlamydia Infections↗
PubMed1986

Health education and public health policies for detection, prevention, and treatment of hypertension.

Health education and policy issues in high blood pressure concern concepts and actions for prevention, early detection, and long-term control. Complementary modes of dissemination of the health education message are a medical preventive ("high-risk") strategy and community-oriented programs ("population strategy"). Today, a clear preventive message can be given to the public to prevent and control high blood pressure in whole communities. Data from a Swiss health survey show avenues for future action. Although not only health information matters to the general population, but also easy access to services ("enabling factors"), factors such as health knowledge and attitudes and the presence of a supporting partner ("predisposing factors") are of additional importance for hypertensive patients. For future action, then, the health message should be intensified, and more research on the nature and kind of information is warranted.

Community Health Services↗
PubMed1983

[Use of muscle relaxation in the primary prevention of ischemic heart disease].

Possibilities of using muscular relaxation as a general hygienic procedure that helps reducing the risk of coronary disease were examined in males and females from an open random population at preventive group sessions. Their ability to learn the techniques of muscular relaxation and the effects of relaxation on arterial pressure were assessed. A course of four group sessions completed by 23.23% of volunteers was sufficient for 86.36% of males and 91.49% of females to learn the command of muscular relaxation. Arterial pressure decreased significantly between the beginning of the first session and the last one (p less than 0.01), the lowered level persisting at the control session in three months' time (p less than 0.01). Muscular relaxation is expected to provide a useful element of preventive population programs aimed at reducing moderately elevated arterial pressure.

Adult↗
PubMed1983

Evaluation and treatment of survivors of sudden cardiac death or nonbradycardic syncope unrelated to coronary artery disease.

The authors describe their clinical strategy and experience with electrophysiologic testing in a group of patients who have had at least one episode of sudden cardiac death or nonbradycardic syncope in the absence of coronary artery disease. Their study shows that for this population programmed stimulation commonly induces ventricular tachycardia, which can then be suppressed by drug therapy.

Adolescent↗
PubMed1994

Mammography screening controversies.

Some organizations in the U.S. recommend mammography screening at 1- to 2-year intervals for those aged 40 to 49 and annually from the age of 50. In Canada and Europe, screening mammography is not recommended for women aged 40 to 49, and mammography every 2 to 3 years for women aged 50 to 69. The screening studies in Europe show no evidence of effectiveness of mammography screening in women aged 40 to 49 in the first 8 to 10 years after initiation of screening. Although at 12 years the recent Swedish overview analysis shows a 13% reduction, this is nonsignificant and the confidence intervals are wide. In the National Breast Screening Study (NBSS) in Canada, annual two-view mammography and physical examinations by carefully trained health professionals were given. In women aged 40 to 49 the ratio of proportions of deaths was 1.36 (95% CI 0.84, 2.21). For women aged 50 to 59, the NBSS evaluated the contribution of mammography over and above physical examination. In spite of detecting many more cancers, mammography did not result in a reduction in breast cancer mortality at 7 years (OR 0.97; 95% CI 0.62, 1.52). Although these results suggest the benefit from screening may be less than assumed, for women over 50, biennial screening to age 74 is probably appropriate in population programs, although careful monitoring will be necessary to ensure that the anticipated effect is achieved.

Adult↗