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Biomedical subjects

P Reith

Publications and source records attributed to P Reith.

6 recordsLinked to original sources

The periodic health examination in college students revisited.

The periodic health examination is a group of tasks carried out by physicians and nurses at regular intervals, but not always yearly, to determine either the risk of subsequent disease or to identify disease in its early, asymptomatic state. The Guide to Clinical Preventive Services, published in 1989 by the United States Preventive Services Task Force, sets common American standards for these procedures. The guide lists those preventive activities recommended for persons aged 19-39 years. Every patient encounter in our student health services should be considered an opportunity for preventive activities. This article offers a simple check list for office use.

Clinical Protocols

Adapting the selective periodic health exam to a college-aged population. Joint American Preventive Services Task Force. Canadian Task Force on Health Care Screening.

The periodic health examination is a group of tasks carried out by physicians at regular intervals, but not always yearly. It is designed to determine either the risk of subsequent disease or to identify disease in its early, asymptomatic state. These tasks include immunizations, health promotion topics, and specific clinical screening maneuvers. This paper seeks to increase awareness of the extensive work being done by the Canadian Task Force on Health Care Screening and the Joint American Preventive Services Task Force in setting standards for the periodic health exam. The exam can be reviewed in the office and urgent-care setting or promoted in health education activities. Knowledge of the new standards for the periodic health exam can help in setting priorities for preventive activities in student health services. Implementation in the college-aged group will require cost considerations.

Female

Prolonged suppression of a corticotropin-producing bronchial carcinoid by oral bromocriptine.

The addition of orally administered bromocriptine mesylate to cyproheptadine hydrochloride therapy completely normalized urinary-free cortisol levels for three months in a 21-year-old woman with Cushing's syndrome in whom results from standard dexamethasone suppression and metyrapone stimulation tests as well as baseline corticotropin levels were originally compatible with a diagnosis of an occult pituitary adenoma. When transsphenoidal exploration of the sella turcica was unsuccessful and hypercortisolism persisted, the source of corticotropin was discovered using petrosal sinus and venal caval catheterization. A 1 X 1.5-cm carcinoid tumor of the lung was identified and removed, thereby correcting the hypercortisolism. The tumor was demonstrated by immunoperoxidase staining to contain corticotropin. Orally administered bromocriptine, with or without cyproheptadine therapy, may be useful in the palliative treatment of some patients with carcinoid or other ectopic corticotropin-producing tumors. We postulate that bromocriptine therapy acted directly on carcinoid tumor cells to directly inhibit corticotropin production by a dopaminergic mechanism.

Administration, Oral