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Biomedical subjects

E Trell

Publications and source records attributed to E Trell.

At least 73 records · Page 4Linked to original sources

Experiences with an interactive computer program for recording biometrical health screening data.

The nurses' measurements of biometrical health screening data comprise the central elements in our multiphasic preventive medical investigation in Malmö. It is also vitally important for the information processing, evaluation and actions of the screening that all test values and other data can be supplied to a uniform computer bank without delay in terms of secondary transferral routines. In our ongoing population investigation projectin Malmö, this has been accomplished by on-line computer programs for the different components of the screening. Here we describe the practical experiences with the subroutine use by the nurses to feed the biometrical test results to the computer bank.

Biometry

Hospitalization and alcohol-related morbidity within three years after screening in middle-aged men.

All men living in Malmö who were born in 1926-1929 were invited for a health screening examination which included, among many other things, measurement of gamma-glutamyltransferase (GGT). They were followed up and within three years after the screening 963 of 4571 men had been hospitalized. They had 17158 hospital days or almost 6 days per individual each year. The impact of alcohol on the admissions was analysed both according to the International Classifications of Diseases and a new design where all the diagnoses were grouped and coded in conditions which were judged to be alcohol-related, potentially alcohol-influenced and non-alcohol-related. Of the total days in hospital, alcohol psychosis and alcoholism accounted for 13.6 per cent. Altogether 29.2% of the days were caused by alcohol-related and potentially alcohol-influenced conditions. GGT values at the screening investigation were significantly increased in 25% of the hospitalized men. Alcohol-related admissions were seven times as many in men with GGT values in the highest quintile compared with those who had values in the lowest quintile.

Alcoholism

Correlations of serum lipids and lipoproteins with gamma-glutamyltransferase and attitude to alcohol consumption.

The correlation of three markers of alcohol consumption: serum concentration of gamma-glutamyltransferase (GT), high density lipoprotein cholesterol (HDL-cholesterol), apolipoprotein AI (Apo AI), and the results of a questionnaire (Mm-MAST) designed to measure the attitude towards alcohol consumption were determined in a population of healthy men aged 48 years. Apo AI (r = 0.27) and GT (r = 0.31) were correlated (P less than 0.001) to the questionnaire score to a similar degree while the correlation between HDL-cholesterol and the questionnaire score was (r = 0.18), somewhat less good but statistically significant (P less than 0.01). There was no correlation between GT and HDL-cholesterol or Apo AI.

Alcohol Drinking

Serum ferritin, gammaglutamyl-transferase and alcohol consumption in healthy middle-aged men.

Serum ferritin was analysed in 169 middle-aged men. Ninety-one were heavy drinkers with increased serum gammaglutamyltransferase (GGT) values in otherwise normal routine screening tests; 39 were from the same birth year cohorts with normal GGT values; and 39 were teetotalers. Increased ferritin values were found in 67% of the heavy drinkers, but only in 2.5% in the two other groups. The mechanisms of the serum ferritin elevation in otherwise healthy alcohol over-consumers are unknown, but heavy drinking should be taken into consideration in the interpretation of increased serum ferritin values in individual cases.

Alcohol Drinking

Carcinoma of the oral cavity in relation to aryl hydrocarbon hydroxylase inducibility, smoking and dental status.

The authors investigated the smoking patterns in a consecutive series of 20 patients with oral cancer and at the same time assessed the aryl hydrocarbon hydroxylase (AHH) inducibility distribution and dental status. The AHH level proved high in 8 patients, intermediate in 7 and low in 5. High AHH inducibility was more common (p = less than 0.001) and low AHH inducibility less common (p = less than 0.001) than in the controls. Dental status was poor in only 2 patients. It is concluded that smoking is a prominent exogenous factor associated with the occurrence of cancer in the oral cavity. Poor dental status seems to be of minor importance.

Adult

Serum-gamma-glutamyltransferase in screening and continuous control of heavy drinking in middle-aged men.

In an on-going population study in Malmö, serum-gamma-glutamyltransferase (GGT) is utilized both in biochemical screening of high alcohol consumption and as a tool in further investigation, treatment and control of middle-aged men with screening GGT in the top decile of the distribution. For this purpose, a special outpatient clinic has been instituted and is described in the present report. The composition of the intervention group and the feasibility of the program are reported for the first 6760 middle-aged male screening participants. A random one-half of the individuals with screening GGT in the top decile were allocated to the intervention group, which after primary dropouts and exclusion of concurrent diseases consisted of 252 individuals who have now been followed between three to six years. On the basis of structured interviews, hazardous levels of alcohol consumption were concluded to be present in 76% of the group. Although one-quarter of the group dropped out of the intervention program, the results indicate that it is feasible to institute an outpatient clinic for individuals with increased GGT levels found in a general health screening examination, to retain most individuals in this outpatient clinic and to consider alcohol habits and consumption levels in relation to the laboratory test value and general physical health status.

Alcohol Drinking

Smoking habits and carboxyhaemoglobin. A cross-sectional study of an urban population of middle-aged men.

In this cross-sectional population study we report on the distribution of carboxyhaemoglobin concentrations in the morning, before smoking, in an urban population of 1037 men born in 1931. The median concentration was the same in non-smokers as in ex-smokers: 0.5%. It increased with increasing daily tobacco consumption. But when carboxyhaemoglobin concentrations are measured in reasonably well-standardised circumstances there are large variations between individuals, even in those who smoke equal amounts of tobacco a day. This makes it difficult to predict the concentration in the individual smoker when only his daily tobacco consumption is known. Measurements of carboxyhaemoglobin concentration should be a valuable complement to smoking history to identify the smoker at high risk of cardiovascular disease, to provide an extra argument to make the patient give up the habit, and to reinforce the efforts of those who try to do so.

Carboxyhemoglobin

Alcohol consumption and premature death in middle-aged men.

All the men living in Malmö born in 1926-9 were invited for a screening examination which included an assessment of alcohol consumption and measurement of gamma-glutamyltransferase (GGT) activity. They were followed for up to four years (median 2) and their mortality assessed. Sixty-two deaths occurred, 41 (0.9%) among the 4571 men who attended the screening investigation and 21 (1.3%) among the 1609 who did not respond to the invitation. Evidence of alcohol abuse or an alcohol-related cause of death was present in 25 (61%) of the deaths among the attenders and 13 (62%) of those among the non-responders. GGT values at the screening investigation were significantly increased in 19 (46%) of those who died, but established risk factors, such as cholesterol and triglyceride concentrations and blood pressure, had little predictive value. Measurement of GGT provided an objective index of alcohol consumption, though the full clinical importance of a raised value needs further assessment. The finding that heavy alcohol consumption was the single most important factor associated with premature death in these middle-aged men has important implications for prevention.

Alcohol Drinking

Interactive computer system for monitoring multiphasic health screening.

In an on-going population screening investigation at the Department of Preventive Medicine in Malmö, an interactive computer system has been developed for monitoring: (i) the electron and invitation of the health screening population; (ii) on-line registration and representation of demographic informations, test results and questionnaires; (iii) generation of the patient files and other listings; (iv) systems for diagnostic and statistical processing and representation. Ten thousand health screening investigations have now been monitored by the system, which is described in this report.

Computers

Hypertension, levels of serum gamma glutamyl transpeptidase and degree of blood pressure control in middle-aged males.

Among the first screened 2439 males born in 1926 and 1927, aged 48-49 years at the time of screening and representing 76% of these age cohorts, uncontrolled or partly controlled hypertension was found in 7.5%. Of these individuals, 30% preferred to remain with their physicians, regardless of the degree of control they had achieved. Among those who were referred to the Hypertension Unit (5.2% of the screened population), elevated S-GT levels (greater than or equal to 1.10 mukat/l) were found in 38.3%, against 18.5% in the two cohorts. During 24 months of treatment and follow-up only two men among the entire group of hypertensives referred dropped out, both were heavy drinkers (greater than 80 g alcohol daily). The mean BP after treatment was significantly lower among men with normal than high S-GT values or in those who admitted to heavy drinking. Of the 99 males treated for more than two years, 82 (83%) were responders (supine DBP less than or equal to 95 mmHg). Of the non-responders, 70% were either heavy drinkers or had abnormal S-GT values. The possible role of alcohol in the pathogenesis of essential hypertension in middle-aged males is discussed.

Alcohol Drinking