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Iron deficiency and dietary factors in Finland.

In connection with a multiphasic screening program carried out in Finland, over 7,000 persons participated in a dietary survey. The method was a diet history interview concerning food consumption and habits during the previous year. The mean intake of meat products was lower in anemic women (Hb less than 12.0 g/100 ml or PCV less than 36 vol%) than in the others and in the intake of liquid milk products was higher in the anemic women. The meat product intake was lower in anemic men (Hb less than 13.0 g/100 ml or PCV less than 41 vol %) than in other men, but the milk consumption of the groups was almost equal. The intake of meat products in iron-deficient women )serum iron less than 50 mu g/100 ml or TIBC larger than or equal to 400 mu g/100 ml) was lower and the intake of milk products higher than in the other women. The intake of meat products in iron-deficient men (serum iron less than 50 mu g/100 ml or TIBC larger than or equal to 400 mu g/100 ml) was lower than in the other men and the milk consumption was almost equal. The results support earlier studies that dietary habits are significant in the etiology of iron deficiency. In the light of this population study the intake of vitamin C also seems to influence iron metabolism.

Adolescent↗

Patterns of menopause: a study of certain medical and physiological variables among Caucasian and Japanese women living in Hawaii.

Comparisons were made between menopausal women and nonmenopausal controls among Caucasians and Japanese living in Honolulu, to investigate the extent of physical changes and clinical symptoms associated with menopause. The analysis was conducted using the multiphasic screening records of 170 menopausal cases and 162 nonmenopausal controls in Caucasians, and of 159 menopausal women and 187 nonmenopausal controls in Japanese. Discriminant function analysis was employed with relevant anthropometric, medical, and physiological variables. After adjusting for the linear and non-linear effects of age, only surgery and medication were retained as significant discriminant variables. Discriminant functions for Caucasian and Japanese groups were not found to be significantly heterogeneous. With regard to the discrimination of the menopausal and nonmenopausal groups, the data suggested that, while no clinical conditions other than those attributable to the effects of aging were significantly associated with the menopausal state, medication and surgical procedures for female disorders were significantly related to menopause.

Adult↗

Work-energy level, personal characteristics, and fatal heart attack: a birth-cohort effect.

In a 22-year followup of 3686 San Francisco longshoremen, a cohort analysis assessed job activity and six personal characteristics in relation to 395 fatal heart attacks. Four cohorts aged 35-44, 45-54, 55-64, and 65-74 in 1951 were studied annually for job shifts affecting energy output and for sudden or delayed death from heart attack by age 75. All subjects underwent multiphasic screening for heavy cigarette smoking, higher blood pressure, history of prior heart disease, obesity, abnormal glucose metabolism, and higher blood cholesterol. The first three of these characteristics added risk of fatal heart attack. The amount of risk varied in the four cohorts. Higher energy output on the job reduced risk of fatal heart attack, especially sudden death, in the two younger cohorts, where less active workers were at threefold increased risk. Lack of this effect in the two older cohorts could imply real differences in their work habits, such as being less energetic in heavy jobs or more energetic in light jobs than the younger cohorts. Or, before the study began, early deaths may have winnowed susceptibles from the two older cohorts. Combined low-energy output, heavy smoking, and higher blood pressure increased risk by as much as 20-fold. By elimination of these adverse influences, this population might have had an 88% reduction in its rate of fatal heart attack during the 22 years.

Adult↗

Alcoholic beverage consumption and breast cancer incidence.

Recent case-control studies have suggested that alcohol consumption may be associated with breast cancer incidence. This report is a retrospective cohort study of over 95,000 women who were members of the Kaiser Foundation Health Plan of Northern California. The stated alcohol consumption of these women was recorded at a multiphasic screening examination taken from 1964 to 1972 prior to any diagnosis of breast cancer. The incidence of breast cancer in this cohort was greater for women who drank, and among these drinkers, incidence increased in an irregular trend with heavier alcohol consumption. Control for the effects of race, education, smoking, and reproductive variables related to breast cancer all but eliminated the overall increased relative risk of drinkers compared with that of nondrinkers. However, the relatively small group of women who stated that they had three or more alcoholic drinks per day (5.2 per cent of the total) had a significantly elevated relative risk of 1.4 (p = 0.035) compared with nondrinkers, despite control for all available confounding variables. No significant interaction effect of smoking and alcohol was found. Women who had less than three drinks per day had no increased relative risk over nondrinkers. The results of this study might be explained either by an unrecognized carcinogenic effect of alcohol on breast tissue or by the confounding effect of other factors associated with heavy alcohol use.

Adolescent↗

Clinical engineering services at the VA Medical Center, Los Angeles.

A large, modern Medical Center requires clinical engineering services to account for all medical equipment utilized in the treatment of the short-visit clinic patient, as well as the critically ill, who require extensive hospital, surgical or medical health care. The clinics act as multiphasic screening systems, providing simple treatment and referral for more extensive medical treatment. The hospital provides the necessary medical systems to accommodate the extensive daily patient flow. Few of the clinics can provide the facilities or machines to handle the expense of newer diagnostic and therapy requirements. Manpower and funding for maintenance today is concentrated in the fast-growing Radiology, Radiation Therapy/Nuclear Medicine, and Laboratory areas of the Medical Center. These departments require service specialists, and large amounts of dedicated funding to balance and insure reasonable maintenance of the newer, high-technology equipment. Growth of such technology in the hospital must be matched by the growth of service professionals in biomedical engineering departments.

California↗

Smoking and health: the association between smoking behaviour, total mortality, and cardiorespiratory disease in west central Scotland.

The relationship of smoking to total mortality and to the prevalence of cardiorespiratory symptoms has been studied in three prospective surveys in west central Scotland in which 18 786 people attended a multiphasic screening examination. The prevalence of respiratory symptoms, and to a lesser extent cardiovascular symptoms, increased with the number of cigarettes smoked, with inhalation, and with a younger age of starting to smoke. A lower prevalence of respiratory symptoms in both sexes was observed in smokers of filter cigarettes than in smokers of plain cigarettes, and in those who smoked cigarettes with lower tar levels, irrespective of whether these were filtered or plain. In general, the relationships found between smoking and mortality were similar to those reported by other workers. Current cigarette smokers had a death rate from all causes which was twice that of those who had never smoked. No difference was found between the mortality rates of smokers of plain and filter cigarettes.

Age Factors↗

Parity and obesity.

Parity was found to be closely related to adiposity and prevalence of obesity in a population sample of 17 688 non-pregnant women aged 25-84. The women took part in multiphasic screening examinations in various parts of Finland in 1966-72. The relationship between parity and obesity was independent of other factors such as +geographical area, region, marital status, occupation, smoking habits, or incapacity for work. Pregnant women were considered to be an important target population for nutritional education.

Adolescent↗

A comparison of the body height of the Israeli-born and immigrants to Israel.

This paper reports a study of body height in the adult Jewish population of Israel, comparing native-born with immigrant groups. The sample tested included 1,411 men and 961 women, all clinically healthy according to the results of multiphasic screening. The phenomenon observed in other immigration-absorbing countries also holds for Israel: native Israelis are significantly taller than their immigrant counterparts. The findings were verified over different age and working activity strata, and thus may be taken to reflect the influence of better socioeconomic and environmental conditions on the bodily development of those born in Israel.

Africa↗

Use of physician services by a middle-aged population in a rural health centre district in southwest Finland. Descriptive distributions.

The use of physician services by a middle-aged population was investigated in connection with a multiphasic screening programme in two rural municipalities in Southwest Finland. The screening programme was attended by 1223 (93.2%) females and 1045 (93.4%) males, 40 to 64 years of age. Two-thirds of the subjects (61% of the men and 69% of the women) had seen a doctor during the previous year because of illness, symptoms or accident. The mean of the face-to-face physician contacts was 2.3 times a year per person, the women having had more contacts (2.4) than the men (2.1). In all, about half (52%) of the subjects had visited the health centre physician during the previous year for the previously mentioned reasons. Ten per cent of the subjects had seen a private specialist and another 10% had seen a physician at an outpatient clinic of a central or district hospital. More than one-third of those who had seen a physician at the health centre had visited the health centre at least three times within a year, whereas only one-sixth of those who had used the services of a private practitioner had seen the private practitioner as often. Proportionately, those visiting mental health offices used the services of a physician the most often, for the majority of them (77%) had seen a psychiatrist at this office at least three times during the year.

Adult↗

Jamestown Medical Clinic System.

Comprehensive health care can be provided in rural and poor areas despite a decreasing number of physicians in those areas. A single physician increased his productivity by 300% to 400% by combining already available resources: specially trained and supervised nurse-practitioners, problem-oriented charting, and multiphasic screening. With emphasis on the nurse-practitioner as the main "person of contact" for the patient, the physician is able to shift from 50% to 75% of his usual tasks to these specially trained personnel. Patients have come to regard the physician as a "consultant" to the nurse-practitioner.

Community Health Services↗

Pulmonary tuberculosis in prisons of the ex-USSR state Georgia: results of a nation-wide prevalence survey among sentenced inmates.

SETTING: The penitentiary system of the ex-USSR state of Georgia. OBJECTIVES: To measure the prevalence of active pulmonary tuberculosis and drug-resistant disease among prisoners. To identify factors associated with active tuberculosis and multidrug resistance (MDR). DESIGN: A comprehensive multiphasic screening survey for tuberculosis. RESULTS: The prevalence of smear- or culture-positive tuberculosis was 5995 per 100,000 prisoners (n = 448 cases among 7473 inmates). Of all the strains, 215 (77.9%) were resistant to at least one drug and 37 (13.0%) were MDR. Independent risk markers associated smear- or culture-positive tuberculosis with included prison stay of 2 years or more, body mass index <20 kg/m2, accommodation in a large size prison, previous anti-tuberculosis treatment, cough of 2 weeks or more and loss of appetite. Risk markers associated with MDR were a prison stay of less than 2 years and being over 25 years of age. CONCLUSIONS: In Georgia, the excess risk for tuberculosis among prisoners is unprecedented, suggesting that prisons represent a significant reservoir of tuberculosis. Only a comprehensive strategy for tuberculosis control in prisons, including prison reform, control of anti-tuberculosis drugs, and prompt and efficient diagnosis and treatment of patients can have an impact on the tuberculosis burden in the prison system.

Adult↗

[Diagnosis and surgical treatment of primary hyperparathyroidism].

Primary hyperparathyroidism (HPP) is increasingly being recognized because of the widespread use of multiphasic screening for hypercalcemia, in patients without clinical signs. Each year develop 100,000 new cases in the United States, females/males 5:2; the peak of incidence is in V-VI degrees decade. We analyze our patients from November 1975 to July 2000. We have performed 112 parathyroidectomy for HPP, 84 females and 28 males, median age 57.5 years. We have examined the surgical options, the value of PTH, calcium, and the number of pathological glands. The Authors discuss the invasive or non-invasive procedures and the surgical treatment.

Adolescent↗

New system for automated extraction and simultaneous determination of serum cholesterol and triglycerides.

We describe an automated system for serum lipid extraction and simultaneous determination of cholesterol and triglycerides, with use of continuous-flow equipment. A sample volume of 100 mul of serum is required, and samples are processed at the rate of 20 per hour, which may be increased with slight loss in precision. Time from sample pickup to recorder readout is about 25 min. The system makes use of established colorimetric reactions, and the values obtained agree with ranges currently reported in the literature. Correlation coefficients for results of the automated and manual methods were 0.98 for cholesterol and 0.99 for triglycerides, and the day-to-day coefficients of variation were 1.8% for cholesterol (1 SD equal to 34 mg/liter) and 3.4% for triglycerides (1 SD equal to 37 mg/liter). The small sample volume, precision, accuracy, speed, and comparative economy of reagents make this system particularly suitable for multiphasic screening, pediatrics, and small-animal research.

Animals↗

[Multiple serial examinations by means of rapid tests in Brandenburg 1974].

In 1974 5,129 inhabitants of Brandenburg took part in a multiphaseal screening which with the help of a combination from anamnestic, clinical and biochemical parameters simultaneously with the mass miniature radiography led to the detection of disturbances of heart and circulatory system, diseases of the kidneys and urinary passage, liver diseases, diabetes and anaemias. The approach as well as the results of these methods which are suitable as action as well as basic examination (internal medicine, general medicine, occupational medicine) are described.

Anemia↗

[Mass screening of gastric cancer--limits and prospects].

Now we have two methods for gastric cancer screening. One is radiological study and another is pepsinogen test. The efficacy of radiological study has been established by the curve of mortality rate of gastric cancer through these four decades. But it is problem for this study that the number of the participants has reduced and the patients who take the examination have been fixed. On the other hand, pepsinogen test is very easy and cheap to take the results. But the efficacy of this is not established, because this test started only twelve years before. According to our research, both tests have the pros and cons. So it is necessary to use both methods to do mass screening of gastric cancer. The capsule endoscopy, which was developed in these years, has held great possibility. It will be used practically near future.

Female↗