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PubMed2002

Screening for diabetes: is it warranted?

BACKGROUND: Diabetes mellitus is estimated to have a worldwide prevalence of 4.6% and afflict 200 million people. The prevalence is accelerating rapidly and the disease has reached epidemic proportions. While type 1 diabetes usually has a dramatic clinical onset, almost half of all those individuals with type 2 diabetes have not been diagnosed. This observation, coupled with the presence of complications at diagnosis and the significant reduction of microvascular complications obtained with tight glycemic control, has led to the recommendation that screening for diabetes be instituted. The American Diabetes Association recommends that adults aged 45 years or more should be evaluated for diabetes by measuring fasting plasma glucose concentrations. CONCLUSIONS: The rationale for screening, evidence that tight glycemic control reduces complications, and the possible roles of Hb A(1c) and autoantibodies in screening strategies are addressed in this review.

Blood Glucose↗
PubMed1993

[Current status and problems of a screening for prostatic cancer in the health facilities in Fukuoka Prefecture].

We analyzed the current status and problems of a screening for prostatic cancer (PCa) through a health examination in 12 hospitals in Fukuoka prefecture. From 1987 to 1991, a total of 16,126 subjects received this. The number of subjects who received this increased every year. In 5 hospitals in which such a screening is optional, however, only about 20% of subjects through a health examination received it each year. Furthermore, most of the subjects were in their 50s or 40s. Those in their 70s or more who are at higher risk for PCa rarely received such screening. PCa was detected in 6 subjects (0.04%) (well differentiated adenocarcinoma: 3, moderate differentiated adenocarcinoma: 3) in 5 years. Five were in stage B and treated with radical prostatectomy and one was in stage C and hormonal therapy was performed. The mean age of the 6 patients was 57.7 year old ranging from 51 to 66. The incidence of PCa detected by a screening in dock increased with age. Prostate specific antigen (PSA) was considered to be more useful for detecting prostate cancer in dock as compared with digital examination (DRE), transrectal ultrasonography or prostatic acid phosphatase because of its relatively high sensitivity (83.3%) and specificity (84.8%). The incidence of PCa detected with combination of DRE and determination of PSA was 0.15% and significantly higher than that detected with DRE alone, 0.01%. These results suggest the need for enlightenment on PCa and the significance of a screening with combination of DRE and determination of PSA through a health examination for detecting early stage of PCa.

Aged↗
PubMed1984

Brief Minnesota Multiphasic Personality Inventory scales to screen for substance abuse.

Research has focused on development of accurate screening instruments to detect alcoholism. The Minnesota Multiphasic Personality Inventory (MMPI) has long been employed, but the utility of previous scales in differentiating substance abusers from normals remains unclear. Conley and Kammeier (J. Consult. Clin. Psychol., 48 (1980) 665) identified seven MMPI items which appeared to be specific to alcoholism. In a replication attempt, this study compared MMPI's for 1403 male and 323 female job applicants and 228 male and 76 female chemical dependency inpatients. MMPI items were chosen through empirical identification of those with greatest endorsement differences. A 13-item scale emerged with an endorsement differential exceeding 45%. Four of the seven Conley-Kammeier items replicated in the 13-item scale. These shorter MMPI scales appear superior to the older 50-item-plus MacAndrew and Holmes scales for screening normal populations, providing cutting scores which yield specificity exceeding 80% with sensitivity greater than 90%. However, results must be interpreted with caution, and limitations regarding the state of the art are set forth.

Alcoholism↗
PubMed1975

Relationship between work environment and anamnestic health status. Use of predictors, indicators and indices for the evaluation of medical and environmental factors.

Experience with computerized medical record systems in handling medical data in hospital and health screening environments has led to the development of a new approach to the evaluation of medical data. Predictors and indicators quantify the "information value" of medical data and can, theoretically, do so for all types of data. This paper describes the methodology and presents the results obtained when the technique was applied to the anamnestic data of the medical history and environmental data about the conditions in the work environment. Over 4,000 individuals who underwent multiphasic health screening were used as a data base for this study. From these 4,000 persons 3,164 were used for the calculation of anamnestic predictors and indicators and 1,013 for the environmental predictors and indicators. Anamnestic environmental indices were calculated upon 77 test individuals so as to correlate the association and dependence of the two indices.

Environmental Exposure↗