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PubMed2003

[Comprehensive health examination ("Otasha-Kenshin") for the prevention of geriatric syndromes and a bed-ridden state in the community elderly. 1. Differences in characteristics between participants and non-participants].

PURPOSE: We conducted a comprehensive mass health examination for elderly subjects aged 70 or above, living in the community, to assess early deterioration to long-term care conditions and promote healthy and successful aging ("Otasha-Kenshin"). In this study, we clarified characteristic differences between participants and non-participants. SUBJECTS & METHODS: A mass health examination was offered in October 2001 to 863 community elderly, including individuals suffering from falls (and fractures), incontinence, malnutrition, depression, mild cognitive impairment and less of functional capacity. Among the total, 438 (50.8%) opted for the "Otasha-Kenshin" examination. Differences in characteristics between the participants and non-participants were examined, parameters including sex and age distribution, self-rated health, functional capacity by the TMIG Index of Competence, depressed status by the General Health Questionnaire (GHQ), subjective well-being by the Philadelphia Geriatric Center Morale Scale: A revision (PGC-MS), frequency of falls, and prevalence of chronic diseases. The comparison was based on the results of measurements from the final survey conducted in 2000. RESULTS: 1) The participation rate in the "Otasha-Kenshin" was 49.0% in males and 51.0% in females. The average age was 75.3 year olds in participants and 76.4 in non-participants, the difference being significant (t = 3.97, P < 0.0001). 2) Non-participants had a significantly lower level of self-rated health than participants. 3) There was no significant difference in hand grip strength between participants and non-participants. 4) Non-participants showed significantly lower level of functional capacity and subjective well-being, and they were more likely to be in a depressed state than participants. 5) There was no significant difference in fall rate between participants and non-participants. 6) The prevalence of hypertension and diabetes (found in more than 5% among the subjects surveyed in 2000) was not significantly different between participants and non-participants. CONCLUSION: With aging of society, new and specialized health maintenance systems for the elderly are essential, both for the prevention of deterioration to a long-term care condition (a bed-ridden status) and for the promotion of successful aging with autonomy. Participants in "Otasha-Kenshin" appear to be healthier and more independent than non-participants who were more frail and at higher risk group of a long-term care condition and a bed-ridden status. The major reason for non-participation in the health examination found in this study was subjective or mental deterioration rather than the presence of chronic illness or any geriatric syndrome per se. Frail elderly people like the non-participants in this study should be encouraged and mentally supported to avoid aggravation of their health status through intensive or specialized health surveillance system such as home-visit nursing.

Aged↗
PubMed1979

A case-control study of hair dye use and breast cancer.

A case-control study of the relationship between hair dye use and breast cancer included 129 breast cancer patients and 193 control women drawn from the records of a multiphasic screening clinic. Information was obtained by telephone interview on a number of risk factors for breast cancer and on variables pertaining to hair dye use: chronologic time, duration, frequency, type, and color. From this, quantitative measures of cumulative hair dye use at various intervals prior to breast cancer (or an equivalent for controls) were obtained. A multivariate risk factor score was used to control for confounding variables. The adjusted relative risks for breast cancer versus hair dye use were greater than unity but were not generally significant. However, integral measures of hair dye use (No. of yr times frequency per yr) were significantly related to breast cancer when confounding variables were controlled. The association between hair dye use and breast cancer was greatest among women over 50 years of age and among those at lower natural risk for breast cancer. An analysis of temporal patterns showed that breast cancer was related mainly to hair dye use 10 or more years before cancer diagnosis. Because of the retrospective nature of the hair dye data and the small sample size, these results require further validation.

Adult↗
PubMed1986

[Epidemiology of minor electrocardiographic anomalies predictive of the occurrence of ischemic cardiopathy].

Common electrocardiographic manifestations (CEM) are predictors of ischemic heart disease (IHD). If precursors of the disease, their risk factors should be similar to those of IHD. This hypothesis has been assessed on results of multiphasic screening recorded in 1976 and 1981, in 1,347 45-65 year old men. Risk factors are social class (blue collar relative risk rr = 2.3), physical activity at work (sedentariness rr = 2.4), systolic blood pressure, no beer consumption and blood urea nitrogen with an exponential risk curve. Cholesterolemia, smoking, diabetes mellitus, overweight and uricemia are not predictors of CEM incidence within 5 years. These results support the idea that CEM are partially asymptomatic expression of IHD; they also have another significance. Subgroups should be individualized and analysis yielded on larger samples. Correlation analysis has been performed between IHD mortality and beer consumption on basis of French counties. A positive correlation (r = 62, p less than 0.01) is opposed to individual results.

Coronary Disease↗
PubMed1978

Parathyroid hormone and hyperparathyroidism: current concepts.

Our expanding knowledge of the physiologic and biochemical factors governing calcium homeostasis has improved our capacity to evaluate hypercalcemia, of which an increased incidence is being discovered through the widespread use of multiphasic screening. Consequently, we are diagnosing mild forms of hyperparathryoidism more often than formerly. The enhanced recognition of virtually symptom-free hyperparathyroidism presents a problem in patient management because the natural history of this form of hyperparathyroidism is unknown and the pathologic lesion underlying the condition may be ambiguous, resulting in difficult decisions in surgical management. Further study is required to resolve this issue in order to provide optimal care for the affected individual.

Animals↗
PubMed1985

[ENT surgery and laboratory medicine--the modern aspects of cooperation].

The value and application of a multiphase screening programme of preoperative laboratory investigations on ENT patients is described and assessed. Appropriate laboratory investigation should be chosen. The methods of investigation should provide information about the patient's general condition, should identify disease which has escaped clinical assessment, which is not connected with the underlying disease, but which could severely handicap a patient undergoing surgery. They are also designed to assist in the medical screening of the general population. The programme includes tests of organ function and of metabolism. The frequency of abnormal laboratory values (less than 2.5% at to longer end of the normal distribution curve or above 5% at the other) was 7.8% for blood sugar, 2.9% for serum creatinine, 4.5% for urea, 11.6% for uric acid in men and 4.8% in women, 9.8% for serum cholesterol, 2.9% for SGOT in men and 20.8% for triglycerides. Tests included in the haemostasiological study were the basic coagulation testing programme (PTT, Prothrombin Time, Thrombin Time and Fibrinogen). Inherited and acquired blood disorders are detected through the full coagulation test programme and assay of the specific coagulation factors and fibrin degradation products. We diagnosed 11 inherited blood disorders in 10,000 patients put through the above screening programme. The problems of diagnosis and therapy of antibody haemophilia are demonstrated by an example of antibody haemophilia of factor VIII.

Blood Chemical Analysis↗
PubMed1982

[Changes in blood pressure figures after a 5-year interval. Analysis of factors for predicting future hypertensives].

11 351 adults were observed five years after a first multiphasic screening at the centre de médecine préventive in Nancy (France). 1 424 became hypertensive. A discriminant analysis was performed on the predictive value within five years of systolic and diastolic blood pressure, body mass index, serum cholesterol, and uric acid, and heart rate. A discriminant variable was calculated by combination of all these parameters. Blood pressure seemed to have by far a stronger discriminative power than all the other variables though they were already disturbed at first screening. Discriminant variable is more predictive than each variable separately. However, further studies should be needed on the predictive value of pathophysiologic factors of hypertension before warranting preventive use of antihypertensive drugs.

Adult↗
PubMedDate not supplied

[Indicators of the polarograms of active serum proteins for oncological examinations].

The possibility to develop a highly productive indicator for polarographically-active substances of blood serum is analysed. A laboratory prototype of the instrument is designed and its serviceability is tested on biological solutions prepared of blood serum taken from healthy and diseased subjects. The method may be useful in primary stages of laboratory investigations to detect oncologic diseases in the course of multiphasic screening.

Blood Proteins↗
PubMed1994

[Asymptomatic hyperparathyroidism. Influence of PTH values on the therapeutic decision].

The majority of patients affected by primary hyperparathyroidism present now in surgical series are little or totally asymptomatic. This is due to widespread use of multiphasic screening for hypercalcemia as far as to more liberal indications for parathyroid exploration. The debate about the need for parathyroidectomy is open in these patients, having few or no signs at all of primary hyperparathyroidism, because conservative treatment has yielded confused results. The authors analyzed preoperative biochemical values and surgical outcome from 26 patients affected by primary hyperparathyroidism. Thirteen cases had overt primary hyperparathyroidism (group A) and 13 had asymptomatic disease (group B). Patients in group A had higher preoperative PTH values than patients in group (p < 0.05). After surgery, the patients in group A showed parathyroid glands which weighted significatively more than ones in group B (p +/- 0.01). Further, a significant correlation between preoperative PTH value and glandular weight was demonstrated in all cases. The authors conclude surgery for patients having mild primary hyperparathyroidism may give some problems related to the very small size of abnormal glands found during operation. We advise a close follow-up for these patients initially without treatment: surgery should be recommended for those showing PTH values higher than 150 pg/ml.

Adult↗
PubMedDate not supplied

[Ambulatory geriatric screening--an overview. II: Evaluation of the effectiveness and current recommendations for screening implementation].

Geriatric screening detects many problems previously unknown to the primary health care physician. In spite of this, a valid judgement can only be made if the effectiveness of the induced intervention is proven. Prospective studies evaluating these screening-induced interventions show diverse results. Nevertheless, international task forces conclude from the evidence of existing studies that there are areas which are effective, efficacious, and enhance the quality of life. It remains a continuing task for research to develop geriatric assessment instruments as well as to set up objective guidelines of intervention in these areas.

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