Screening recommendations for the elderly.

BACKGROUND. Studies have documented the potential contributions of preventive health care programs. Yet little is known about which screening tests should be included in public health programs for older persons. This study offers recommendations regarding these tests. METHODS. The recommendations come from synthesizing the findings of the US Preventive Services Task Force, the literature, and the consensus of experts in geriatrics, gerontology, and health policy research. The literature was evaluated to identify methodologically sound studies of the prevalence of selected disorders and benefits and availability of screening procedures for those disorders. Experts from various fields specializing in the care of the elderly formed panels to assist in evaluating the literature and providing further information from gerontological and public health perspectives. RESULTS. We recommend vision testing for refractive error; inspection of the skin surface for fungal infection and skin cancer, drug eruptions, and xerosis; a history for symptoms of xerosis; audiometric testing for presbycusis; surveys for hearing loss; otoscopic inspection for cerumen impaction; dental examination for caries; measurement of blood pressure for hypertension; and breast examination and mammography for cancer. CONCLUSIONS. Our study suggests that these screening procedures are useful for public health screening programs. More information is needed on the effects of screening services on the health and functioning of older persons.     

Indoor 222Rn levels in New York State, North Carolina, and South Carolina

Results are presented from approximately 9000 Rn measurements made in New York state, North Carolina, and South Carolina. The estimated statewide geometric mean concentrations were 28.1 Bq m-3 and 55.8 Bq m-3 for basements in New York state, 27.5 Bq m-3 for living rooms and 108.9 Bq m-3 for basements in North Carolina, and 25.0 Bq m-3 for living rooms in South Carolina.     

Copper uptake and transfer to the mouse fetus during pregnancy

Accumulation of 64Cu in the 14-d mouse fetus was measured following intravenous injection of the dam with 64CuHis2. Concentration of 64Cu in the placenta increased rapidly over the first 4 h, thereafter remaining constant. Transfer to the fetus was linear over 48 h with little evidence of storage in the liver. Maternal serum levels decreased initially, concurrently with increased 64Cu levels in the maternal liver, but did not subsequently increase. Immediately following injection, as much as 40% of the radioactivity was in the nonalbumin fraction, and approximately 37% of that fraction (18% of total) was greater than 30,000 molecular weight. After 24 h, up to 60% of the 64Cu was still found in the albumin peak. The data suggest that the fetus can obtain its Cu from maternal ceruloplasmin but does not exclude the possibility that transfer occurs from the exchangeable (albumin/amino acid) Cu pool of the maternal plasma. In a second experiment, mice at different stages of gestation were injected with 64Cu and killed 4 h later. Total Cu levels and 64Cu uptake into the maternal tissues or into the placenta did not change with increasing gestation. Both total Cu and 64Cu uptake in the fetus and fetal liver increased to a maximum on d 16. Levels in the liver decreased thereafter to term, whereas levels in the rest of the fetus remained approximately constant. The pattern was similar whether the results were expressed per organ or per gram of fresh weight.(ABSTRACT TRUNCATED AT 250 WORDS)     

The influence of the helmet respirator on peak flow rate in aluminum potroom

The efficiency of the Racal Airstream helmet respirator in improving peak expiratory flow rates (PEFR) and symptoms (dyspnea, wheezing, and cough) in aluminum potroom workers with respiratory complaints was assessed in 19 workers. Peak expiratory flow readings and symptom recording from a 2-week working period with use of the respirator were compared with a period when the 3M 9906 disposable mask was used. The study was designed as a randomized, parallel, cross-over study with five or six daily measurements of PEFR and daily symptom recording. A significant number of workers (15) had a higher mean peak flow in the helmet period than in the nonhelmet period (p less than 0.01); symptoms did not improve significantly in the helmet period. Objective evidence of respiratory protection was observed for the group of workers as a whole, but the effect on symptoms as well as individual effect on peak flow was minor in the majority of the workers.     

Plasma lecithin-cholesterol acyltransferase activity and plasma lipoprotein composition and concentrations in kwashiorkor

Plasma lecithin-cholesterol acyltransferase (LCAT) activity, lipoprotein composition, and lipoprotein concentrations were measured in 21 children with kwashiorkor before (day 1), during (day 10), and after treatment (day 30). Day 1 LCAT activity (78.2 mumol.L-1.h-1) was decreased with respect to day 10 (139.2 mumol.L-1.h-1, P less than 0.001) and day 30 (108.0 mumol.L-1.h-1, P = 0.08). Plasma total cholesterol (TC), cholesterol ester (CE), and lipoprotein CEs (VLDL, IDL, LDL, and HDL) were reduced relative to days 10 and 30 (P less than 0.001). Before treatment HDL composition was abnormal. On days 1, 10, and 30, the respective mean HDL-apolipoprotein A-I (apo A-I) concentrations were 23.33, 39.66, and 36.08 mumol/L. LDL-apo B concentrations were 0.40, 0.68, and 0.56 mumol/L (P less than 0.01, days 10 and 30 vs day 1). LDL particles on day 1 were decreased in number, depleted of CE, and laden with triacylglycerol and surface lipids. LCAT activity on day 1 correlated with LDL-CE linoleate (P less than 0.05, r = 0.48). Reduced plasma LCAT activity is an important factor related to abnormalities in lipoprotein composition and concentrations.