Showing papers on "Mass screening published in 1969"
194 citations
TL;DR: Some Pitfalls in the Evaluation of Screening Programs as discussed by the authors were identified as one of the most common pitfalls in the evaluation of screening programs in the early 1970s. Archives of Environmental Health: An International Journal: Vol. 19, No. 3, pp. 412-415
Abstract: (1969). Some Pitfalls in the Evaluation of Screening Programs. Archives of Environmental Health: An International Journal: Vol. 19, No. 3, pp. 412-415.
111 citations
TL;DR: Screening for asymptomatic bacteriuria in the adult non-pregnant female population in many instances fails to detect urinary tract infection at an early and reversible stage.
Abstract: The clinical, laboratory, and radiological findings in a group of 107 non-pregnant bacteriuric women and 88 controls have been compared. A previous history of urinary tract infection was more commonly obtained from the bacteriuric women. The means of the diastolic blood pressures, serum ureas, and erythrocyte sedimentation rates were significantly higher in the bacteriuric group, and acquired renal abnormalities were demonstrated in 18% of the bacteriuric women as compared with 4% of the controls. It is concluded that screening for asymptomatic bacteriuria in the adult non-pregnant female population in many instances fails to detect urinary tract infection at an early and reversible stage.
78 citations
TL;DR: With the glucagon test, all patients with deficiency of the phosphorylase system showed a rise in blood glucose no different from that of normal children, so the statement of Sokal, Lowe, and Sarcione (1962) that a rapid rise of 50 mg./100 ml.
Abstract: The majority of patients with glycogenosis of the liver have one of three types of enzyme deficiency: deficiencyofglucose-6-phosphatase, ofthe debranching enzyme system, or of the phosphorylase system (Illingworth, 1961; Hers and Van Hoof, 1968). The severity of the disease and of its manifestations, such as hypoglycaemia and acidosis, is related to the underlying enzyme defect (van Creveld and Huijing, 1965). Treatment of patients with liver glycogenosis is dietary. The diet aims at reducing the effects of the metabolic disturbance and must vary with the type of enzyme defect (Fernandes and van de Kamer, 1965, 1968). It is important to start dietary management as early as possible, and therefore to diagnose the disease and the enzyme deficiency involved, at an early age. The definitive diagnostic procedure is assay of the enzymes, either in liver tissue orfor debranching enzyme and phosphorylase-in the leucocytes. But it would be useful to have available simpler tests to screen children in whom liver glycogen disease is suspected. Various screening procedures have been recommended, such as the epinephrine tolerance test (Howell, Ashton, and Wyngaarden, 1962), glucagon tolerance test (Hug, 1962; Lowe et al., 1962), and intravenous tolerance test with fructose (Hers, 1959) or galactose (Schwartz, Ashmore, and Renold, 1957). Ockerman (1967) has reviewed the application of these tests. In our experience, they often have drawbacks. With the glucagon test, all our patients with deficiency of the phosphorylase system showed a rise in blood glucose no different from that of normal children. Thus, the statement of Sokal, Lowe, and Sarcione (1962) that a rapid rise of 50 mg./100 ml. or more in blood glucose after intramuscular glucagon virtually rules out liver glycogen disease, does not hold for this group of patients. Moreover, the glucagon test is usually performed after prolonged fasting
51 citations
TL;DR: The phenomenon of leukopedesis in gingival and periodontal tissues was measured by counting the number of orogranulocytes migrating into the mouth during repeated intervals of 30 seconds and classified as a non-subjective laboratory routine for indexing oral inflammation.
Abstract: The phenomenon of leukopedesis in gingival and periodontal tissues was measured by counting the number of orogranulocytes migrating into the mouth during repeated intervals of 30 seconds. Measurements were carried out with a computerized electronic cell grading system and classified as a non-subjective laboratory routine for indexing oral inflammation. For orogranulocytic migratory rate (OMR) readings above 1.2 X 106/30 sec, a minimum of three determinations is required for reliability. Single readings suffice for OMR's below 0.5 X 106/30 sec, which indicates that the system is suitable for mass screening purposes.
47 citations
TL;DR: It is only recently that a critical appraisal of the value of a low-phenylalanine diet in preventing the mental defect in patients with phenylketonuria is getting a critical assessment.
Abstract: ALTHOUGH phenylketonuria was described by Asbjorn Folling1over 30 years ago, it is only recently that we have begun to appreciate the full clinical spectrum of the disorder and to get a critical appraisal of the value of a low-phenylalanine diet in preventing the mental defect in such patients.2 Much of this confusion has come about because of differences in methods of ascertainment for phenylketonuria. In the beginning, it was felt that the disorder could only be detected in the patient who developed clinical symptoms, most prominently mental retardation. As a result, it was believed that all patients with phenylketonuria were mentally defective3and the occasional "atypical" phenylketonuric person with normal or near-normal intelligence was considered to be sufficiently unusual as to be worthy of reporting separately.4Since treatment was of little benefit once mental deficiency was already present, very few data were available on treatment
43 citations
TL;DR: There were significantly more urinary tract abnormalities found in the bacteriuric subjects than in the controls; diastolic blood pressure serum urea and ESR differed significantly between the 2 groups.
Abstract: To establish the value of screening for significant bacteriuria in an adult nonpregnant population clinical radiological and laboratory findings of a group of 107 women with asymptomatic bacteriuria are compared with a matched control group. Dysuria frequency and nocturia and loin pain and fever were more frequent in the group of bacteriuric patients than controls. Oral contraceptives were used nearly twice as often by the bacteriuric subjects than controls; diastolic blood pressure serum urea and ESR differed significantly between the 2 groups. There were significantly more urinary tract abnormalities found in the bacteriuric subjects than in the controls. Screening was ineffective in preventing the development of symptoms.
37 citations
TL;DR: In this paper, the results of a survey have shown that plasma urate levels are of little or no value as a screening test for the majority of conditions in which abnormal levels have been described.
Abstract: Uric acid is a major end-product of purine and nucleic acid metabolism. Possibly as a result of increased nucleic acid turnover, hyperuricaemia has been found in a large number of diseases (Bywaters and Glynn, 1964). Inborn errors ofpurine metabolism are now known (Kelley et al., 1968). Of these, the Lesch-Nyhan syndrome is the most remarkable and is frequently associated with high levels of urate in serum (Lesch and Nyhan, 1964). This condition is characterized by overproduction of uric acid as a consequence of deficiency of the enzyme hypoxanthine-guanine phosphoribosyl transferase (EC 2.4.2.8) (Seegmiller, Rosenbloom, and Kelley, 1967). From these considerations, it was felt that measurement of plasma urate in children in hospital might be of value as a general index of purine and nucleic acid metabolism, and might be closely connected with growth. Furthermore, Nyhan (1968) stressed the need for data on plasma urate levels in childhood. The purpose of the present communication is to go some way towards fulfilling this need, with special reference to children attending hospital, and to assess whether or not plasma urate measurement can be used as a screening test for the many conditions in which abnormal urate levels have been described. The results of the survey have shown that plasma urate levels are of little or no value as a screening test for the majority of conditions in which abnormal levels have been described. Mean levels for the present hospital population have been obtained, and the results suggest that there is a fall in mean plasma urate levels at the time of the mid-growth spurt. In addition, high levels of urate have been found in some cases of unexplained abdominal pain.
34 citations
TL;DR: This seminar discusses the possibilities of dichotomizing the female U.S. population for screening purposes into those more or less likely to develop breast cancer, based on the hypothesis that systemic dissemination is a function of tumor mass.
Abstract: This seminar discusses the possibilities of dichotomizing the female U.S. population for screening purposes into those more or less likely to develop breast cancer. The idea is based on the hypothesis that systemic dissemination is a function of tumor mass and the facts that breast cancer is the most frequent cancer in women and that the breast in an exposed organ amenable to physical screening methods. Without subdividing those with increased risk about 40 million women per year would require screening to reach about 6-7% of those with cancer potential. Some relative risk factors are 1.35-2.3 for single women 1.15-1.6 for infertile 1.5-2.0 for fewer than 3 children 0-2.3 for never having breast fed 1.5 for menarche before age 15. Using these figures graphs were drawn which could concentrate 75-80% of potential cases within 60% of the population; i.e. a risk of about 2.5 for all those with 2 or fewer children. There is a study in progress on Guernsey which suggests that excretion of hydroxycorticosteroids and etiocholanolone may predict 75-80% of cases within 60-65% of the population. Or the 2 methods could be combined to concentrate over 80% of cases within 50% of the population although double screening would be needed.
31 citations
TL;DR: The results of phenylalanine to tolerance tests performed during a collaborative study on the causes for high phenylAlanine levels, associated with normal serum tyrosine, in newborn infant screening programs are described.
Abstract: The WIDESPREAD use of mass screening for blood phenylalanine among newborns has led to the recognition that in addition to phenylketonuria (PKU), 1 there may exist several closely related clinical and biochemical abnormalities, which have been variously labeled "hyperphenylalaninemia associated with phenylalanine transaminase deficiency," 2 "persistent hyperphenylalaninemia," 3-5 "phenylalaninemia," 6 and "transient hyperphenylalaninemia." 7,8 This report describes the results of phenylalanine to tolerance tests performed during a collaborative study on the causes for high phenylalanine levels, associated with normal serum tyrosine, in newborn infant screening programs. Materials and Methods Definition of Cases. —The present survey covers the family members of all infants with persistent blood phenylalanine levels of 6 mg/100 ml or higher and with blood tyrosine levels less than 5 mg/100 ml, seen during 1964 to 1966, and in a few instances, during the first quarter of 1967, from 11 centers located in seven states (California, Colorado, Illinois, New
29 citations
Journal Article•
TL;DR: This procedure offers a rapid (5 to 6 minutes), convenient, and safe means for large-scale cystic fibrosis screening programs for screening infants and children.
Abstract: An evaluation is made of newly developed specific-ion electrodes for determining sodium and chloride on the skin surface following the stimulation of the sweat glands by pilocarpine iontophoresis. This procedure offers a rapid (5 to 6 minutes), convenient, and safe means for large-scale cystic fibrosis screening programs for screening infants and children. Caution is urged in the evaluation of the reading since a failure to sweat may result in a misleading value.
TL;DR: It was found that the disease appeared to occur less frequently in southern portions of the nation, and a geographical variation in the prevalence of Paget's disease of bone might suggest possible etiological factors.
Abstract: There appear to be striking variations in the prevalence of Paget's disease of bone in different portions of the world. Sissons (7) reported the disease to be more frequently encountered in Great Britain and certain other European countries than in the United States or Scandinavia. The disease is seen rarely, if at all, in some Asian and African populations. It is the impression of many radiologists that the prevalence of Paget's disease varies remarkably in different portions of the United States. These impressions were confirmed by one of the authors (H. D. R.) in questionnaires sent to many hospital radiologists in the continental United States. Although no distinct geographical distribution was clearly apparent from the replies to this questionnaire, the disease appeared to occur less frequently in southern portions of the nation. Since a geographical variation in the prevalence of Paget's disease of bone might suggest possible etiological factors, an attempt was made to obtain information about the f...
TL;DR: The results of the survey indicate that the panoramic radiographic screening examination provides a simple and rapid method of recording the general dental health of a large population and furnishes information concerning dental treatment requirements.
TL;DR: The results indicate that further evaluation of thermography as a screening technique for breast cancer is warranted and should be in the form of a controlled clinical trial.
Abstract: A collaborative study of 3,518 patients in several medical centers was designed to determine the sensitivity and specificity of thermography as compared to mammographic and clinical examinations. For 862 patients who had breast surgery or a biopsy, the sensitivity and specificity was 0.823 and 0.784 respectively for physical examinations, 0.721 and 0.798 for thermographic reading with clinical data, and 0.703 and 0.807 for mammography. Of additional interest was the observation that each of the procedures (physical examination, mammography, and thermography) selects different subgroups of cases. The results indicate that further evaluation of thermography as a screening technique for breast cancer is warranted. Such evaluation should be in the form of a controlled clinical trial.
TL;DR: This communication reports on a survey of 36,172 infants, in whom a measured volume of plasma was examined by partition chromatography, and concludes that "normal" variation in plasma amino acid composition at this age has been determined.
Abstract: OPPORTUNITIES to survey the newborn human infant for the occurrence of a wide variety of aminoacidopathies and to determine "normal" variation in plasma amino acid composition at this age have been rather limited. Most mass screening programs have focused on a single amino acid. The adaptation of simple modified partition chromatographic techniques 1,2 to the analysis of amino acids in whole blood or plasma provided the opportunity to perform mass screening for many aminoacidopathies and to evaluate the worth of this endeavor. It was a subject of great interest to Dr. Efron, 3 and one which she pioneered with Dr. MacCready and other colleagues until she could work no longer. In this communication we report on a survey of 36,172 infants, in whom a measured volume of plasma was examined by partition chromatography. Our report follows that completed by Dr. Levy 4 after Dr. Efron died, in which her survey
TL;DR: A screening procedure is described which can be used to separate the great majority of normal persons from those with a lack of the enzyme galactose transferase.
Abstract: A screening procedure is described which can be used to separate the great majority of normal persons from those with a lack of the enzyme galactose transferase. The method is designed to be used on dried blood spot eluates which remain after a phenylalanine determination has been performed. The optimum conditions for this test are described, and data are presented from a preliminary study of more than a thousand infants and several confirmed galactosemics.
TL;DR: One of the introduction of mass screening programs for the detection of inborn errors of metabolism 1 almost inevitably reveals a variety of new artefacts which those who deal with these diseases must learn to recognize.
Abstract: THE introduction of mass screening programs for the detection of inborn errors of metabolism 1 almost inevitably reveals a variety of new artefacts which those who deal with these diseases must learn to recognize. We describe here one of these artefacts:D-methioninuria due to ingestion ofDl-methionine-fortified infant formula. Report of a Case The patient, the second-born of male dizygotic twins delivered in a hospital in a nearby community at 32 weeks' gestation, weighed 1,814 gm (4 lb) at birth. His brother weighed 1,561 gm (3 lb 7 ounces). The mother, a primipara, was convalescing from viral hepatitis complicated by myocarditis when spontaneous labor began. The infant spent the first three days in an incubator. "Very foul stools" were noted at 4 days of age, and this was more or less persistent throughout his nursery course. After initial 5% dextrose feedings, the infant was given a cow's milk formula, and
TL;DR: A biochemical abnormality affects the quality of mucus, and results in pancreatic duct obstruction, and progressive lung damage as a result of respiratory infection.
Abstract: Cystic fibrosis (CF), transmitted by a single autosomal recessive gene, affects 1 in 2500 of the population. A biochemical abnormality affects the quality of mucus, and results in pancreatic duct obstruction, and progressive lung damage as a result of respiratory infection. Thirty years ago it is probable that almost all affected babies died of pneumonia in the first two years of life. Over the past generation the prognosis has improved substantially for children fortunate enough to be diagnosed early, and some of these are now reaching adult life with relatively little lung damage. There is, however, still substantial illness and mortality in childhood, and much of this could be avoided by earlier diagnosis. The lungs are structurally normal at birth, but have a built-in tendency to progressive lung damage; by the time respiratory problems lead to a diagnosis irreversible lung damage may have been done. About one case a day is born in the United Kingdom, the average paediatrician sees about one new case a year, and the average family doctor will have one new case in his practice in his working life. The natural history of CF suggests the desirability of making a diagnosis before it becomes clinically obvious. The requirements of a screening programme are that it should be harmless, reliable, accurate, cheap, and acceptable to the very large number of unaffected people who will be subjected to it. None of the existing methods of diagnosis satisfy the last two criteria. The most widely used diagnostic test is the measurement of sodium or chloride content of sweat, the flow of which has been stimulated by pilocarpine iontophoresis. Other exocrine glands are, however, similarly affected, and Johnston (1956) reported
TL;DR: Little evidence could be found that high-speed drills have altered the hearing threshold of Minnesota dentists, but more hearing damage was attributed to gunfire and other sources even though more than half the dentists tested thought that drill noise had affected their hearing.
Abstract: Little evidence could be found that high-speed drills have altered the hearing threshold of Minnesota dentists. More hearing damage was attributed to gunfire and other sources even though more than half the dentists tested thought that drill noise had affected their hearing.
TL;DR: Routine vitamin B12 assays are justified only when fully-automated techniques have become available and the discovery of pernicious anaemia in only two cases is concluded.
Abstract: Vitamin B12 assays and inspection of peripheral blood films performed on 1,004 consecutive new patients over the age of 50 admitted to mental hospital led to the discovery of pernicious anaemia in only two cases. It is concluded that routine vitamin B12 assays are justified only when fully-automated techniques have become available.
TL;DR: Analysis of urine for cadmium is of value in preventive medicine, and should be used for periodic check-ups on those occupationally exposed.
Abstract: Lehnert, G., Klavis, G., Schaller, K. H., and Haas, T. (1969).Brit. J. industr. Med.,26, 156-158. Cadmium determination in urine by atomic absorption spectrometry as a screening test in industrial medicine. Cadmium was determined by atomic absorption spectrometry in the urine and serum of 18 workers exposed to cadmium dust and fume in a zinc smelting plant. In all cases the concentrations of cadmium in the serum were within the normal range, but those in the urine were elevated. The elevated urine concentrations showed that the exposed group had taken up more cadmium than normal, although they showed no clinical symptoms of cadmium poisoning. Analysis of urine for cadmium is therefore of value in preventive medicine, and should be used for periodic check-ups on those occupationally exposed.
Journal Article•
TL;DR: Cytologic examination of 195 patients with clinically diagnosed leukoplakia revealed signs of malignancy in 4% after a single examination and in 8.8% after repeated smears in a five-year observational period.
Abstract: Cytologic examination of 195 patients with clinically diagnosed leukoplakia revealed signs of malignancy in 4% after a single examination and in 88% after repeated smears in a five-year observational period Positive cytologic results occurred mostly in patients with erosive leukoplakia
TL;DR: The present communication reports on the occurrence of a type named "persistent mild hyperphenylalaninemia" in the Israeli population, and the genetic nature of this type is discussed.
Abstract: CLASSICAL PHENYLKETONURIA (PKU) may be defined as a hereditary metabolic disorder due to phenylalanine hydroxylase deficiency, leading to persistently very elevated blood phenylalanine levels (above 20 mg/100 cc) and urinary excretion of phenylpyruvic acid. Recently introduced programs for mass screening of newborn for the detection of this disease revealed that hyperphenylalaninemia may represent a sign of several distinct disorders.1-4In the present communication, we report on the occurrence of a type named "persistent mild hyperphenylalaninemia"4in the Israeli population. The genetic nature of this type is discussed. Methods Screening for PKU in the newborn was performed by the method of Guthrie and Susi5usually at the age of 3 to 5 days. When a presumptive positive result was observed, additional samples of blood dried on filter paper were requested and examined by the Guthrie method as well as a paper chromatographic screening procedure for amino acids.6
TL;DR: This spot-test procedure is recommended for mass screening and diagnosis of red cell glutathione peroxidase deficiency and good agreement with quantitative determination of the enzyme activity by a spectro-photometric method was found.
Journal Article•
TL;DR: A rapid and simple screening test for histidinuria has been developed by the authors and is based on the inhibition by histidine of the blue color formed by the reaction of cupric ion and bis-cyclohexanone oxaldihydra-zone.
Abstract: Histidinemia, a childhood disease associated with mental retardation, can be identified by the presence of histidinuria. A rapid and simple screening test for histidinuria has been developed by the authors and is based on the inhibition by histidine of the blue color formed by the reaction of cupric ion and bis-cyclohexanone oxaldihydra-zone. The formation of a colorless solution in this test should identify all urine specimens in which the concentration of histidine is greater than 60 mg/l00 ml and most specimens in which the concentration of histidine is greater than 20 mg/100 ml. By appropriate dilution of a urine sample, the screening test may be used to estimate, semi-quantitatively, the concentration of histidine in urine.
TL;DR: An on-line system to analyze cardiac arrhythmias was developed by the use of a small scale digital computer, and would serve as a diagnostic aid for physicians in the routine electrocardiographic interpretation and the mass screening of heart diseases.
Abstract: An on-line system to analyze cardiac arrhythmias was developed by the use of a small scale digital computer. In this system, the electrocardiographic signals were fed into the computer, being adjusted within the input range by a buffer amplifier. The analog signals of each electrocardiogram were converted to the digital form at the rate of 1, 000 per second for 20 seconds by the analog-to-digital converter insatlled in the computer. Thus, the digitized electrocardiogram was processed by the diagnostic program. The computation time for the parameter measurements and the interpretation of an electrocardiogram by this system was about 15 seconds. The automated systems of this type would serve as a diagnostic aid for physicians in the routine electrocardiographic interpretation and the mass screening of heart diseases.