Showing papers on "Mass screening published in 1970"

Cervix cancer death rates and mass cytologic screening.

Abstract: Death rates for cervix cancer and total uterine cancer among women 20 years old and older have decreased significantly in Jefferson County, Ky., from 1953-1967. Death rates have not changed significantly in Kentucky outside of Jefferson County during this time period. The average age at time of death from cervix cancer is 7.6 years greater for Jefferson County residents during the last 3 years of the study compared to the first 3 years. The only known factor which could account for these observations is a mass cytologic screening program for cervix cancer in Jefferson County; there was no such mass screening effort in the rest of the state.

The "at risk" register: a statistical evaluation.

Abstract: In the past decade there has been considerable discussion about the policy of the early selective screening of children at high risk of suffering from handicapping conditions which are not apparent at birth. This policy was advocated by Lindon (1961) and Sheridan (1962), who felt that universal screening of all infants was not practicable at that time. Sheridan in particular considered that it was essential to keep children 'at risk' under surveillance until their development was seen to be progressing en tirely normally. They recommended that local authorities kept 'At Risk' registers of vulnerable children, and this recommendation was reiterated by the Sheldon Committee Report (Ministry of Health, 1967) and by a working group of the World Health Organisation (1967). Nevertheless in 1967 Oppe and Walker, who re viewed the functioning of such registers in the U.K. and Scotland respectively, found that the detection rate based on selective screening was disappointing (Oppe, 1967; Walker, 1967). They attributed this largely to the difficulty of defining precisely the factors which put an infant 'at risk'. This tended to make the registers longer and longer, in some authorities comprising as many as 60% of all live births, thus negating the advantages of selective screening. Other authors confirmed the disappoint ing results of the 'at risk' policy and criticized the concept itself as being inherently unsound (Richards and Roberts, 1967; Rogers, 1967; Hamilton, Richards, Barron, Mackie, and Finlayson, 1968). Forfar (1968) also felt that selective screening was not a satisfactory substitute for universal screening but considered that the 'at risk' register should be retained as an additional safeguard. The critics of the concept of selective screening based their arguments largely on the fact that no local authority has managed to achieve the goal forecast by Lindon (1961) namely, that the screening of a small group, 10 to 20% of all births, would identify the majority of those with 'invisible' handi caps. However, to our knowledge there has been no serious attempt to assess the actual benefit of differentially devoting resources for the screening of children at different risks, as opposed to screening only the children at high risk. The former is a policy which common sense alone would dictate. It is possible to construct a mathematical model of the functioning of a system of selective screening for handicap, based on certain assumptions, and in particular one which relates the amount of re sources available for a child to the probability of detecting an 'invisible' handicap. Such a model can be used to calculate the optimum size of the group and the division of the resources between this group and the remaining children in a population, in order to detect the greatest number of handicaps for a fixed amount of resources. In the following account we describe such a model and its use in conjunction with data from the National Child Development Study (Pringle, Butler and Davie, 1966).

Hepatitis-associated Antigen and Antibody in Haemodialysis Patients and Staff

Abstract: The screening of a dialysis population for the presence of hepatitis-associated antigen (H.A. antigen) has proved to be of value in locating a probable source of infection and in terminating an outbreak of hepatitis by early detection of H.A. antigen positive patients and staff.

A reliable early symptom of bronchial or tracheal rupture

Abstract: A tracheal or bronchial rupture is a severe lesion which is frequently overlooked during the initial post-traumatic period. The best results in the treatment of such ruptures are obtained by the earliest possible restoration of the continuity of the air passages. Early reconstruction, however, depends on early diagnosis. The diagnosis is established with certainty by means of bronchoscopy. The symptom of `deep cervical emphysema' is presented as an aid in selecting, from the many accident victims with chest injuries, those who should be submitted to bronchoscopy for immediate identification of any rupture of the major air passages. This deep cervical emphysema is readily recognizable on an antero-posterior radiograph of the cervical region and upper mediastinum.

Stimulus, Response, and Observer Variables in the Auditory Screening of Newborn Infants

Abstract: Behavioral responses of 144 healthy neonates to actual and simulated presentations of three different high-frequency sounds of 85 dB SPL were studied. Stimuli were a narrow-band noise centered at 2...

Evaluation of Rubella Herd Immunity During an Epidemic

Abstract: The effectiveness of herd immunity as a method of protecting rubella-susceptible individuals during epidemic conditions was evaluated. Six groups of Marine trainees were followed longitudinally through a rubella epidemic. Levels of herd immunity in these groups ranged from 87% to 100%. All susceptible men developed rubella infection with a 2:1 inapparent to apparent infection ratio. In a military population rubella is characterized as an endemic disease with seasonal epidemics. Arthritis and arthralgia were found in 21% of 292 cases of rubella in adult men. Vaccination of selected susceptible adult women is needed.

Genetic Aspects of Hearing Impairments in Children

Abstract: An analysis of the results of hearing measurements on a year class of 14-year-olds at Stockholm schools comprising 10,778 children has been made. The hearing tests were performed as screening audio...

High-Voltage Electrophoresis in Urinary Amino Acid Screening

Abstract: High-voltage electrophoresis at two different pH's of amino acids in urine is described. The method was used for screening mentally retarded patients and patients with neurological disorders. The aminoacidopathies detected in the material were phenylketonuria, homocystinuria, histidinemia, cystin uria, normoglycinemic glycinuria, and cases with increased histidine ex cretion. The excretion of ampicillin-produced spots was observed in patients with ampicillin medication.

Accuracy of screening methods for the diagnosis of breast disease.

Abstract: Clinical examination, thermography, and 70-mm. mammography were performed in 891 patients—414 presented to hospital with symptoms of breast disease and 477 were asymptomatic. Comparison of the diagnostic accuracy of these methods showed that neither thermography nor 70-mm. mammography has a useful place as an isolated screening procedure for breast cancer. In fact, we consider such a policy dangerous.

Method of examination of cell samples using a radioactively tagged dye

Abstract: A sample of cells from a body under investigation is treated with a radioactively tagged substance which is determined to be selectively absorbed by one or more predetermined cell types sought to be identified either as disease producing cells or abnormal cells of the body and distinguished from other cell types. The radioactively tagged substance is aborbed in different amounts by some cells and rejected by other cells. After treatment and washing, the level of radioactivity of the cell sample is sensed in order to determine from the degree of absorption of the radioactively tagged substance information about the presence of absence of disease. The technique may be applied to mass screening for disease of a particular type or types by collecting and identifying similar samples from many subjects and using a predetermined common standard of radiation level to eliminate those samples which are clearly free from disease.

Response to the written invitation in a gynecological mass screening by cytology arranged in Helsinki in 1966.

Abstract: The present study was made to find out about reasons for non-participation in mass screening. The material of the study consisted of the women invited to mass screening in Helsinki in 1966. These women were of ages 40 and 50 and their total number was 6,569, of whom 1,566 did not accept the invitation. An inter- view and questionnares sent by mail brought in a total of 986 replies from women who had participated in the screening and 753 replies from women who had not. The results showed that were relatively seen more single women among the non-participants, as well as those who according to classification by the occupation of the women themselves belonged to the first socio- economic group. Those who stayed away from the screening would discuss and read about cancerous dis- eases less often and would be of the opinion that there is too much talk about these questions nowadays. The alleged reason for non-participation' was in 35 % of the cases that the women had seen a gynecologist for an examination in the course of the past year; 10 yo did not come because they felt quite well, and 14 % did not have the opportunity to arrange for a suitable time to have a smear taken. Of those who did partic- ipate in the screening, 72 yo said that they had gone because it was »good to go just to be sure», and 10 % went because it was simple to go to be examined. By adjustments of age, employment, and marital status, the effects of these could be studied. It was noted that age did not play an important role in the material of the present study. Housewives would some- wha more often than women employed outside home stay away, in particular those who had had no child- births or four or more childbirths. The study aimed at identifying a possible risk group which in addition to the fact that it had not partic- ipated in mass screening would neither in the course of the past year have been examined by a gynecologist nor had a smear taken. Such women totaled 420 in the group of non-participants, which equals 56 %. It was found that more than a half, or 56 %, were single women, whereas their percentage in the total of non- participants was 22. Widowed and divorced women also appeared on an average more often in the risk group: 19 yo vs. 16 yo in the total of non-participants. The percentages of housewives and married women em- ployed outside home did not in a significant manner differ from each other within the risk group, but it was noted that the risk group also included hous- wives who either had no children or had 4 or more children. Even women who were alone in charge of a family, i.e. widowed and divorced women, would more often than usually stay away if they had 4 or more children. It was common to the risk group that the women belonging to it would read about and dis- cuss cancerous diseases less often and also be of the opinion that there was too much talk about these subjects. The results were also compared with those of earlier studies and it was found that there is reason to direct an intensified educational activity particularly to the risk groups mentioned above.

Diabetes in the aged: underdiagnosis and overtreatment

Abstract: In keeping with the already known high prevalence of diabetes among residents of the Jewish Home for the Aged, Toronto, annual screening disclosed an average incidence of 25.5% of abnormal glucose tolerance (two-hour post-glucose blood sugars above 140 mg./100 ml.) in residents not known to be diabetic.Forty-five (47%) of the 94 residents with abnormal screening values were considered subsequently to be diabetic according to our criteria.Long-term follow-up, particularly of 81 residents initially normoglycemic in 1964-5, confirmed that the natural course of glucose tolerance in this population was one of progressive deterioration.By contrast, improvement amounting to remission has been demonstrated in nine out of 20 residents several years after they had been declared diabetic, and is thought to have been induced by dietotherapy.Moderate hyperglycemia per se did not cause symptoms in these almost always keto-resistant and usually aglycosuric aged diabetics, who often claimed they felt better when hyperglycemic. Hypoglycemia was an ever present danger when anti-diabetic medication was used; it was the main reason for undertreatment.So far, data from our long-term study have not shown morbidity to be markedly increased in the diabetics, and mortality was found to be evenly distributed among diabetic and non-diabetic male residents. However, in the females there was a clear correlation between mortality rate and the diminished glucose tolerance.What may appear as overdiagnosis of diabetes in the aged is recommended in the hope that early institution of dietary treatment will delay the development of clinical diabetes and the need for anti-diabetic agents. This, in turn, would prevent iatrogenic hypoglycemia. It would also reduce the severity and frequency of spontaneous hypoglycemia which, we believe, occurs more commonly in the early phase of diabetes in the aged than is generally realized.

Breast Cancer Found on Repetitive Examination in Mass Screening

Abstract: Both clinical examination and mammography remain important in repetitive screening. If either modality had been omitted, a substantial number of cancers would have been undetected. Absence of axillary nodal involvement remains substantially higher in the screened group than in the control. In subsequent screening, overall figures for lack of gland involvement have reached 75% as compared to 44% in the control group. On initial examination, the clinician was more successful in the small glandular breast and in the under-50 age group. In subsequent screening, the differences remained but a narrowing of the gap was apparent.

Screening for Lead Poisoning

Abstract: As one deeply interested in the problem of childhood lead poisoning, I am glad to see that the American Academy of Pediatrics has recently issued a statement on this important but neglected pediatric problem.1 This comprehensive statement will be a useful guideline to pediatricians and other health workers. However, I am concerned about the screening tests recommended for lead poisoning. The statement "Pending improvements in the analysis of lead in blood, the urine ALA test of Davis and Andelman and the analysis of lead in hair, which are currently under study, offer the best substitute for the purpose of mass screening" would have been correct if it were made 2 years ago when these tests were first reported, before they were studied by other investigators.

Effect of phosphate and non-phosphate buffers on thermolability of unstable haemoglobins.

Abstract: A GROUP of hereditary non-spherocytic anaemias have been shown to be associated with unstable haemoglobins through the application of a simple screening test for thermolability involving incubation of haemolysate at 50° C in phosphate buffer (pH 6.5–7.4; 0.1 M)1–3. Unstable haemoglobins form a precipitate within a few hours but normal haemoglobin remains in solution. We have encountered two families with this type of anaemia whose haemoglobins demonstrated little or no precipitate in these conditions, but formed copious precipitate in the presence of non-phosphate buffers—observations which led us to wonder whether the recently described effects of phosphates on the oxygen-binding properties of haemoglobin4–7 might not also modify the heat stability of the molecule.