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The primary aim of the study was to evaluate practice differences in reported morbidity in the second and third national morbidity surveys (1970/71, 1981/82) and to discuss their cause. A secondary aim concerned the validation of trends identified from analysis of the data from the total populations in the practices. Altogether 19 practices participated in both surveys. Annual prevalences (that is, the number of patients attending the general practitioner with a condition per 1000 persons at risk) were examined for: all conditions; each of three categories of seriousness of disease; diseases aggregated by chapter of the International classification of diseases; and each of 130 rubrics of the disease classification. Annual prevalence for 'all conditions' was approximately the same for males in both surveys, whereas for females there was an increase. In both sexes, annual prevalence for 'serious conditions' increased slightly and for 'trivial conditions' increased substantially. For 'intermediate conditions', there was a modest decrease in males. In the analysis at ICD chapter level, substantial increases in prevalence occurred in infectious diseases, nervous system diseases, circulatory diseases, genitourinary diseases, musculoskeletal diseases, symptoms, signs and ill-defined conditions, injuries and poisonings. Decreases were found in blood diseases, mental disorders and digestive diseases. Among 130 individual conditions examined, increased annual prevalence was found for mumps, fungal infections, hypothyroidism, diabetes, gout, senile dementia, angina, left heart failure, catarrh, hay fever and asthma, orchitis, acne, osteoarthritis and for some symptoms. Decreases were found for iron deficiency anaemia, anxiety state, refractive errors, haemorrhoids, chronic bronchitis, functional disorders of the stomach, carbuncle and skin infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Changes in practice morbidity between the 1970 and 1981 national morbidity surveys. 187 71

A systematic health screening programme for the elderly aged 55 years and above was implemented in the first Senior Citizens' Health Care Centre (SCHCC) in 1986. This programme was expanded to two more SCHCCs by 1989. The first 1,224 clients aged 55 years and above, who attended this programme in the first three SCHCCs were studied in this paper. The characteristics of the elderly who voluntarily attended the SCHCCs for health screening were studied with respect to their referrals, socio demographic status, whether they had regular physician care, the existing medical problems and the new medical problems picked up at health screening. Of those screened, 49.6% were referred for the programme by relatives and self, and 28.2% by community centres, thus, showing that community and family supported the programme. Only 7.2% of referrals to the screening programme came from general practitioners and 4% from polyclinic doctors. It is interesting to note that 40% of clients had no regular physician care. About two thirds (57.2%) had one or more existing chronic medical conditions or disability at the time of screening. The majority with existing conditions had hypertension (24.8%) and diabetes (15.5%). Other existing conditions were ischaemic heart disease (6.2%), cataract (3.9%) and asthma (3.6%). The pick-up rate of medical conditions among the clients at the time of health screening was 38.6% for the whole group. This showed a rising trend from the younger to the older age groups being 29.4% in the age group 55 to 64, to 45.8% in the age group 65 to 74, and 51.4% in the age group 75 years and above (p less than 0.001). Some of the topical issues related to a health screening programme for the elderly have been discussed.
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PMID:Health screening for the elderly--the Singapore Senior Citizens' Health Care Centres' experience 1986-1989: an overview. 192 75

Results are reported from a population-based study of 249 cases of pancreas cancer and 505 controls carried out in Toronto, Canada, between 1983 and 1986. Lifetime consumption of coffee and alcohol and medical histories were assessed by personal interviews. No evidence of any association was found with different types of coffee or alcohol after adjusting for smoking, calories and fibre intake. There was a significant increased risk associated with a history of diabetes mellitus within 5 years of cancer development. A protective effect of a history of some allergic conditions, hay fever, eczema and asthma, was observed, although the relative risks were not significant (p value greater than 0.10).
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PMID:Coffee and alcohol as determinants of risk of pancreas cancer: a case-control study from Toronto. 199 45

Several workers reported an increased susceptibility to hepatitis B virus (HBV) in immunosuppressed patients. A study was carried out on 4 groups of supposedly immunocompromised patients for hepatitis B surface antigen (HBsAg), and anti-HBs. The 4 groups of patients were suffering from: Leprosy, Bronchial asthma, Diabetes and hepatosplenic Schistosomiasis. Serum specimens were obtained from 137 patients representing the 4 groups and from a control group of 25 healthy individuals. All sera were tested by ELISA technique for HBsAg and anti-HBs. Results indicated that HBsAg carrier rate was 4% for the control healthy group, 7% for Bronchial asthma, 10% for Diabetes, 24% for Leprosy and 28% for hepatosplenic Schistosomiasis. On the other hand, the anti-HBs was 21% for the control group, 29% for Schistosomiasis, 55% and 58% for Diabetes and Bronchial asthma respectively and 74% for Leprosy. This study shows that immunosuppressed patients particularly those suffering from leprosy and hepatosplenic Schistosomiasis experience higher HBsAg carrier rate than the control group for the endemic hepatitis B (6-7 times higher for leprosy and Schistosomiasis). An important observation was the diminished anti-HBs rate in hepatosplenic Schistosomiasis patients, despite the highest HBsAg carrier rate they exhibited. This may be due to an immunological defect, resulting in an unsatisfactory antibody response and chronic hepatitis B antigenemia. In Egypt, where Schistosomiasis is prevalent (40-50%), the problems caused by hepatitis B infection are increased.
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PMID:Hepatitis B virus infection among immunocompromised patients in Egypt. 213 6

Since the first report by Bang and Dyerberg regarding the apparent beneficial effects of a fish oil-enriched diet on the incidence of atherosclerotic heart disease in Greenland eskimos, a considerable number of studies have been performed regarding the effects of omega-3 polyunsaturated fatty acids on the prevention and treatment of a variety of disease states not necessarily related to atherosclerosis. Studies have been performed on healthy volunteers and in patients with hyperlipidaemia, atherosclerotic vascular disease, diabetes, asthma, psoriasis and chronic renal insufficiency, amongst others. Positive effects on platelet activity, lipid profile, blood rheology and blood pressure--all factors which are presumably of importance in the pathogenesis of atherosclerotic disease have been noted in these studies, albeit with a wide range of variability. Some negative effects also appear to exist. However, some general conclusions can be made regarding the effects of a fish oil-enriched diet.
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PMID:Fish oil: a panacea? 214 59

Authors treated and checked 474 patients with acute myocardial infarction (AMI) during 5 years. The occurrence of hypertension was 37.15% of the total number of patients but this rate was 51.37% for women patients. Obesity, hyperlipidaemia and diabetes mellitus were the most frequent of the risk factors on the patients with hypertension. Asthma cardiale and acute arrhythmias were slightly more frequent early complications and cardial decompensation was a slightly more frequent late complication. The number of myocardial reinfarctions was the same both in the case of hypertensive and normotensive patients under the circumstances of parallel normalization and keeping the tension and serum cholesterol on the normal level.
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PMID:[Incidence and role of hypertension in the development and recurrence of acute myocardial infarct in a 5-year case load]. 218 98

The relation of ventilatory function to overall mortality has been studied in 662 male and 2048 female never-smokers who during the period 1976-1978 participated in the Copenhagen City Heart Study, a prospective community study of more than 14,000 men and women randomly selected from the general population of the City of Copenhagen. Until the end of 1986, 195 subjects who said they were never-smokers died. Mortality was analyzed using the proportional hazards model of Cox. In addition to measures of ventilatory function, the mortality analysis included age, sex, body-mass index, alcohol consumption, school education, diabetes mellitus, heart disease and bronchial asthma as confounding factors. Forced expiratory volume in 1 second (FEV1) as a percentage of that predicted, forced vital capacity (FVC) as a percentage of that predicted and the ratio of FEV1 to FVC were significant risk factors for mortality among both sexes. The relative risk of death associated with a 50% decrease in FEV1 and FVC as a percentage of a predicted value was 1.65 and 1.81, respectively. This study confirms that lowered ventilatory function is a strong risk factor for mortality among never-smokers of both sexes.
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PMID:Spirometric findings and mortality in never-smokers. 221 76

All visitors to a general health survey in 1979, 17,140 men and 14,371 women, completed a questionnaire on smoking habits, exposure to asbestos, silica and welding fumes, and diseases such as pleural effusion, pneumonia, cough, asthma and diabetes. Seven per cent of the men reported exposure to asbestos, 10% to welding fumes, and 6% to silica. Among those who reported work related dust exposure there was a higher proportion of smokers, and smokers exposed to dust smoked more tobacco per day than non exposed smokers. In the group of men 30-59 years of age, who did not indicate exposure to occupational pollutants 2.7% reported previous pleural effusions. However, among asbestos exposed men of the same ages, the prevalence was more than doubled (5.7%, p less than 0.01). This finding was highly significant in a logistic regression model where age and smoking habits were included. The data indicate that 10% or more of diagnosed cases of pleurisy could be associated with previous asbestos exposure.
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PMID:Association between exposure to asbestos and pleural effusion. Results from a questionnaire study of 31,000 persons. 221 61

This study assesses whether nonhospitalized adolescents with chronic diseases differ from their healthy peers on standardized measurements of depression, self-esteem, and life events. The study group consisted of 80 patients (20 with sickle cell disease, 40 with asthma, and 20 with diabetes). All patients had been admitted at least twice in the preceding year, had their disease for at least 2 years, and were between the ages of 12 and 18. The control group consisted of 100 adolescents, matched for age and socioeconomic status, from local schools. All subjects completed a questionnaire compiled from the Beck Depression Inventory (BDI), the Rosenberg Scale of Self-Esteem, and the McCutcheon Life Events Checklist. Adolescents with chronic disease had higher depression scores (p less than 0.001) and lower self-esteem (p less than 0.001) than their healthy age-matched controls. There was no statistically significant difference in life events between the chronic disease and control groups. Depression, self-esteem, and life events did not differ significantly among the three disease groups. These findings suggest a need for intervention strategies to address depression and low self-esteem in adolescents with chronic disease.
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PMID:Depression, self-esteem, and life events in adolescents with chronic diseases. 226 97

Four hundred ten adolescents, ages 14-16 years, completed a questionnaire concerned with their understanding of the social and emotional consequences of AIDS and 5 other illnesses (lung cancer, German measles, chicken pox, asthma, and diabetes). Pupils distinguished between the diseases on all measured items, but younger pupils were more likely to believe that individuals were personally responsible for the onset of AIDS, lung cancer, and diabetes. The data are discussed in terms of the implications for health education campaigns.
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PMID:How adolescents compare AIDS with other diseases: implications for prevention. 232 12


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