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PubMed1993

Fitness in a U.K. screening sample--a comparison with the Canadian population.

Fitness measurements were compared from approximately 12,000 men and 5,000 women attending the BUPA Health Screening Centre, London, with published Canadian levels. The mean (+/- SD) predicted VO2-max values in the BUPA group were 35.1 (+/- 9.2) and 30.0 (+/- 8.4) ml/kg/min for men and women aged 15-64 years, respectively. These compare with means of 44.1 and 34.3 in men and women of the same age in Canada. A comparison of flexibility measurements showed that in all age groups the BUPA subjects were less flexible than their Canadian counterparts, on average 28.7% and 25.1% lower for men and women, respectively. Comparison of grip strength showed BUPA values to be on average 8.1% lower in men and 9.5% lower in women than the Canadian levels. Analysis of variance showed that the fitness measurements reflect the recorded physical activity in the BUPA sample, and in particular the predicted VO2-max and flexibility exhibit linear relationships with age and exercise levels.

Adolescent↗
PubMed1999

[Voiding condition in elderly males examined prostate cancer screening in total health check and the effect of subjective urinary symptoms on quality of life].

PURPOSE: We investigated the prevalence of lower urinary tract symptoms and the effect of subjective urinary symptoms on quality of life (QOL) in elderly males examined prostate cancer screening in total health check from April 1996 to March 1997. PATIENTS AND METHODS: A total of 922 eligible examinees 50 to 70 years old completed a questionnaire with questions worded similarly to those of the international prostate symptom score (I-PSS) and AUA Impact index score and so on. RESULTS: The prevalence of moderate to severe symptoms was 19.6%, which increased with age. I-PSS was well correlated aging but not prostate size. The most prevalent symptoms were nocturia (61.1%), frequency (50.0%) and weak stream (47.7%). There was good correlation between symptom severity and QOL and AUA Impact index scores. While QOL was correlated with obstructive and irritative symptom scores, wish for treatment was associated mainly with irritative symptoms by multiple regression analyses. However, some examinees (15.5%, 28/181), who had moderate to severe symptoms, did not feel a decrease of QOL in daily life. CONCLUSIONS: A large percentage of elderly men 50 years old or older experienced symptoms. However, subjective urinary symptoms did not always correlate with QOL in some individuals. We should independently consider not only symptom severity but also QOL and AUA Impact index score in clinical decision making.

Age Factors↗
PubMed1988

Effect of laboratory error on the identification of persons with hypercholesterolemia in an employee health service.

Cholesterol is a major risk factor for coronary heart disease. Of 117 employees seen consecutively in the Tennessee State Employee Health Service voluntary screening program, 86 (74%) had cholesterol levels above the reference range reported by a commercial clinical laboratory. This was three times greater than the calculated expected number of 29 (25%, 17 at moderate risk, 12 at high risk for coronary disease). Age and sex adjustment using Lipid Research Clinic guidelines reduced the number with elevated cholesterol to 55 (47%, 24 at moderate risk, 31 at high risk). Split sample cholesterol assays run independently by the commercial laboratory and a university laboratory showed excellent correlation (r = 0.99, commercial laboratory = 1.0 (university laboratory) + 10.8), but a systematic difference of 12.4 mg/dL (SD = 6.4 mg/dL, paired-t = 9.63, p less than 0.00001) between the two laboratories. Further adjustment for this difference reduced the number with elevated cholesterol to 41 (36%, 26 at moderate risk, 15 at high risk). This experience illustrates how small systematic laboratory errors in cholesterol determination can greatly exaggerate the number of persons reported to have clinically important cholesterol elevations. Clinical laboratories should report age and sex adjusted cholesterol reference ranges and provide clients periodic quality assurance reports that their measurements of cholesterol levels are accurate.

Adult↗
PubMed1981

EPSDT impact on health status.

Early and Periodic Screening, Diagnosis and Treatment (EPSDT), a large-scale operational screening program which has generated a tremendous volume of data on the sociodemographic characteristics and health status of Medicaid-eligible children, seems to provide an ideal context within which to evaluate the effectiveness of preventive child health care. Concerns about health care expenditures generally, and the effectiveness of preventive child health services specifically, lead to the question of whether the impact on the health status of the children served can be measured without significantly adding to the cost of these services with primary data collection. We employed a quasi-experimental research design using administratively-generated data from an operational EPSDT program to estimate program impact on the prevalence of serious abnormalities among the children served. We found that, compared either to themselves across time or to a control group, a representative sample of 1831 children had almost 30 percent fewer abnormalities requiring care on rescreening. The ability to demonstrate the impact of EPSDT using these data suggests, among other things relevant to policy, that a national EPSDT monitoring system could be developed that would be cost-effective and could lead to program improvement.

Child↗
PubMed1979

Neonatal hypothyroidism detected by the Northwest Regional Screening Program.

The Northwest Regional Screening Program to detect congenital hypothyroidism in infants born in Oregon, Montana, Alaska, and Idaho (combined birthrate of 69,000/ yr) was added to our ongoing screening program in 1975. The program utilizes dried blood filter paper specimens collected routinely in the first few days of life in all four states and again at about 6 weeks of age in Oregon only. The screening test consist of an initial thyroxine (T4) measurement; a thyroid-stimulating hormore (TSH) determination is performed on those specimens with T4 concentrations in the lowest 3% group. Serum samples obtained by venipuncture are requested for confirmation of the diagnosis. In the first two years of the program, 25 infants with primary hypothyroidism were detected amont 110,667 infants screened, a frequency of 1:4,430. Fourteen cases of thyroxine-binding globulin deficiency were also detected, a frequency of 1:7,900. Using the T4 followed by TSH testing approach, the frequency of request for repeat specimens was 0.4% in Oregon and 0.05% in the other states. The cost per specimen was $1.96. The majority of infants lacked clinical signs or symptoms of hypothyroidism; only one infant was clinically suspected of having hypothyroidism prior to detection. The most common neonatal symptoms were constipation, lethargy, and prolonged jaundice, while the most common physical signs were hypotonia, umbilical hernia, and large fontanels. Thyroid scans showed the most common etiology to be thyroid aplasia, followed by an ectopic gland, hypoplasia, and goiter. Serum T4 concentrations were lowest in those infants with aplasia, intermediate in infants with an ectopic gland or hypoplasia, and normal in the infant with the goiter. Neonatal hypothyroidism varies in degree and has several different causes; the capacity to secrete thyroid hormone, the duration before hypothyroidism becomes clinically manifest, and possibly the eventual prognosis for intellectual function depend on the nature of the underlying cause. While the mean age at treatment was 59 days, the goal of diagnosing congenital hypothyroidism and treating affected infants by 1 month of age seems realistic.

Congenital Hypothyroidism↗
PubMed1988

Prevalence of hypercalcaemia in a health survey: a 14-year follow-up study of serum calcium values.

Among 16,401 subjects attending two health screenings, in 1969 and 1971, 176 showed hypercalcaemia on both occasions, i.e. serum calcium values above 2.60 mmol l-1. The prevalence of hypercalcaemia increased in women with advancing age and occurred in close to 3% of those above the age of 60, whilst in men it was found in less than 0.7% in all age groups. The mean serum calcium concentration in women above the age of 50 was significantly higher than in men. This observation could at least partly explain why hyperparathyroidism (HPT) is more often diagnosed in females. Only nine persons were initially referred for neck exploration. Most of the others were not even notified of the biochemical disturbance and thus it was possible to study the serum calcium values in an unattended cohort until follow-up after 14 years. In the hypercalcaemic patients there was little or no increase in serum calcium during these years. In no patient did the serum calcium level rise above 3.0 mmol l-1. Altogether, 24 patients from the initial cohort were subsequently operated on for primary HPT but there were only two further cases of verified HPT, which developed during the follow-up period, in those who had been clearly normocalcaemic at the health surveys. In conclusion, hypercalcaemia, presumably caused by primary HPT, is common but apparently develops slowly and with little risk of a progressive rise of serum calcium concentrations.

Adult↗
PubMed1989

[A study on six cases of renal cell carcinoma detected by renal ultrasound during health screening].

From April 1986 to March 1988, 7,800 subjects (3,887 men and 3,913 women, age from 24 to 80 years, with a mean age of 48.7 years) underwent renal ultrasound during a screening by our Health Service. Of these subjects 29 were suspected to have solid masses in the kidneys. Further examination with computerized tomography (CT) was employed. Four angiomyolipomas and 16 malformations of the kidneys were diagnosed clinically at that time. Among 9 subjects who underwent complete urological evaluation including excretory urography (IVP), CT and renal angiography 6 malignant renal tumors were disclosed. Six patients were treated by radical nephrectomy. In this report we studied the 6 patients whose tumors were pathologically diagnosed as renal cell carcinoma (RCC). The six patients were 48 to 60 years old with a mean age of 55.8 years. There were 4 men and 2 women. There are no signs or symptoms referable to RCC. In 1 patients microscopic hematuria was detected via a laboratory study. Erythrocyte sedimentation rate (ESR) was slightly evaluated in 4 patients. In the 6 patients, the renal tumors were diagnosable by CT and all tumors had positive findings for malignant neoplasms angiographically. An IVP, without nephrotomography, did not reveal a small tumor growing in the upper pole of the right kidney of 1 patient. Surgical specimens were 180-475 g in weight. Tumors, were found in the right kidneys (2) and in the left kidneys (4), were well circumscribed. The size of the tumors measured from 3 to 7 cm in the longest axis. Pathological diagnosis was made as renal cell carcinoma 3 with G1, pT2a, 2 with G2, pT2a and 1 with G2, pT2b.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Renal Cell↗
PubMed1968

Organic brain dysfunction and child psychiatric disorder.

The total population of 11,865 children of compulsory school age resident on the Isle of Wight was studied to determine the prevalence of epilepsy, cerebral palsy, and other neurological disorders. With the use of reliable methods, children selected from screening of the total population were individually studied by means of parental interviews and questionaries, neurological examination and psychiatric assessment of each child, information from school teachers, and perusal of the records of hospitals and other agencies. The association between organic brain dysfunction and psychiatric disorder was studied by comparing the findings in the children with epilepsy or with lesions above the brain stem (cerebral palsy and similar disorders) with those in (1) a random sample of the general population, (2) children with lesions below the brain stem (for example, muscular dystrophy or paralyses following poliomyelitis), and (3) children with other chronic physical handicaps not involving the nervous system (for example, asthma, heart disease, or diabetes).Psychiatric disorders in children with neuro-epileptic conditions were five times as common as in the general population and three times as common as in children with chronic physical handicaps not involving the brain. It was concluded, on the basis of a study of factors associated with psychiatric disorder, that the high rate of psychiatric disorder in the neuro-epileptic children was due to the presence of organic brain dysfunction rather than just the existence of a physical handicap (though this also played a part). However, organic brain dysfunction was not associated with any specific type of disorder. Within the neuro-epileptic group the neurological features and the type of fit, intellectual/educational factors, and socio-familial factors all interacted in the development of psychiatric disorder.

Adolescent↗
PubMed1991

[Clinical study on low body temperature in health subjects].

During last year, 931 men aged 51.0 +/- 9.5 years participated in our hospital's 3-day health screening. Their axillary temperature were taken 3 times per day (twice each, at 6:00 a.m., 2:00 p.m. and 6:00 p.m.) during their 3-day stay and the mean axillary temperature was determined for each subject. In 72 among all subjects, the mean axillary temperature was below 36 degrees C. These 72 subjects were classified as low-temperature individuals with normal temperature below 36 degrees C. This study was designed to compare low-temperature subjects with mean axillary temperature, on various factors, such as age, degree of obesity, liver function, renal function, lipids, electrolytes, and biochemical data (blood glucose, serum amylase, and CPK). This study also included seasonal changes in these low-temperature subjects. The following results were obtained. 1) Age was most closely related to low-axillary temperature, and the degree of obesity (modified Broca-Katsura method) had second significant relation. The low-axillary temperature was in common in subjects over 60 years and was also common in obese subjects, regardless of their age. 2) No seasonal effect was observed with low-temperature subjects. 3) Only the age and the degree of obesity (modified Broca-Katsura method) showed negative correlation independently with the mean axillary temperature. (For age, the correlation coefficient was Y = -0.006539X + 36.491, while for obesity it was Y = -0.004536X + 36.203.) Therefore the older and the more obese the subjects, the lower the mean axillary temperature.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Methods of the National Check Bus Project.

OBJECTIVES: Prevention at the worksite is considered increasingly important. This paper describes the methods used in a nationwide prevention campaign performed at a large Swiss bank and a Swiss industrial company. The aim of this project was to encourage general health awareness among company employees. We also aimed to provide the companies with general health analyses of their staff as a basis for future health promotion. Furthermore, new screening methods were evaluated in the field of research. METHODS: Participation in the programme was voluntary and free of charge. The programme targeted all 25,243 employees of the two companies in all regions of Switzerland. A mobile unit was available on site. The programme included a written health questionnaire and medical examinations (e.g., blood pressure, blood tests, ultrasound of the common carotid artery, osteodensitometry, examinations of the eye, etc). Analysis of individual test results, information brochures, and a telephone information service were also provided. Based on the data of the individuals, the "health status" of the employees of the two companies was analysed. The companies did not have access to the data of the individuals. The programme ran from August 1996 to August 1998. RESULTS: With a total of 10,321 persons taking part in the project, the participation rate was 41%. For the different examinations offered, patterns of participation were identifiable that varied with age, hierarchical status within the concern, body mass index, and number of physical complaints of the employee. Some of the variables showed the same trend for different tests, while others showed opposite trends. CONCLUSIONS: Participation in worksite health promotion programmes is dependent on a complex system of individual and structural variables that need to be considered when planning worksite health promotion programmes. Consideration of specific target population characteristics, including motivations and incentives as well as structural constraints is likely to improve participation rates in worksite health promotion programmes among employees.

Adolescent↗
PubMed1980

Detecting unsuspected thyroid dysfunction by the free thyroxine index.

The free thyroxine index (FTI) was used in 2,704 adults to detect unsuspected thyroid dysfunction. Among 2,581 adults found to be clinically euthyroid without thyroid medication, 2,571 had a truly normal FTI (121 to 360) and ten had a falsely abnormal FTI (seven less than 121, three greater than 360). Among 25 subjects with newly diagnosed thyroid dysfunction, there were eight hyperthyroid (prevalence, 0.31%) and 14 hypothyroid (prevalence, 0.50%) subjects. The sensitivity of the FTI was 1.0, and the specificity was 0.996. The predictive value of an abnormal FTI with a prevalence of 0.81% was 67%. The cost to find a new case averaged $127. The annual incidence of symptomatic hyperthyroidism was 0.05%; of hypothyroidism, about 0.08%. We conclude that the FTI is cost-effective for case finding in thyroid dysfunction.

Aged↗
PubMed1988

Cataract extraction. Risk factors in a health maintenance organization population under 60 years of age.

Risk factors for cataract extraction in a young (less than 60 years of age) urban health maintenance organization population were evaluated in a case-control study. The subjects (72 case-control pairs) subscribed to the Kaiser Permanente Medical Care Program in the San Francisco Bay area and had cataract extraction between 1976 and 1980. All patients had visual acuity of at least 20/40 OU, documented before development of cataracts. Thirty-six (50%) of the 72 cataract extraction patients had at least one known risk factor for cataract formation, including trauma, intraocular inflammation, diabetes mellitus, syphilis, oral or topical steroid use, or previous eye surgery. Male patients were found to be a mean of 4.3 years younger than female patients, and diabetics were found to be a mean of 3.5 years older than nondiabetics. Variables found to be related to cataract extraction in univariate analysis included diagnosis of diabetes mellitus, a family history of cataracts, pulse rate, white blood cell count, and syphilis.

Adolescent↗