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PubMed2006

Relationship between aortic calcification and stroke in a mass screening program using a mobile helical computed tomography unit.

BACKGROUND: It is reported that there is a significant relationship between the calcification of the aortic arch detected by chest X-ray examination and stroke. However, the relationship between stroke and aortic calcification (AoC) detected during a mass screening using a mobile helical computed tomography (CT) unit remains unknown. METHODS AND RESULTS: The study population consisted of 2,618 subjects (1,345 men, and 1,273 women; mean age, 52.9+/-13.8 years) who participated in a mass CT screening for lung cancer and tuberculosis. In the present study, 28 subjects (18 men, and 10 women; mean age, 65.9+/-13.5 years) had a past history of cerebral infarction. There were no subjects with a past history of intracerebral or subarachnoid hemorrhage. The frequency of AoC was significantly higher in the infarction group who were older than 50 years of age. In logistic regression analysis, the AoC was a stronger contributor of infarction than sex, age, and risk factors. Furthermore, the odds ratio of AoC for subjects with a past history of infarction increased as the number of calcified segments increased, and these values were 1.82 (95% confidence interval (CI) 1.06-3.15) in men, and 2.53 (95% CI 1.12-5.75) in women. CONCLUSIONS: These results suggest that detection of AoC during mass chest screening using a mobile helical CT unit is an effective way to evaluate the risk of cerebral infarction.

Adolescent↗
PubMed1996

Serum calcium and survival in a large health screening program.

There is evidence that hyperparathyroidism is associated with increased morbidity and mortality. It is not known, however, whether elevated serum calcium (S-Ca) by itself is associated with those risks. We, therefore, examined mortality rate in relation to a single S-Ca value obtained at screening of a large population (n = 33,346) during a mean follow-up period of 10.8 yr. A survival analysis was performed, comparing groups with S-Ca values above different defined limits with those below these limits, adjusting for age and date of screening. We found that men less than 50 yr of age at screening (n = 21,131) with S-Ca greater than 2.45 mmol/L exhibited a 20% increased mortality rate compared with those with lower S-Ca values (odds ratio = 1.2; P < 0.005), whereas those with S-Ca greater than 2.60 mmol/L had a doubled rate (odds ratio = 2.0; P < 0.0002). Men less than 50 yr of age with S-Ca levels between 2.51-2.55 mmol/L exhibited a 50% increased risk of death from all causes compared with those with S-Ca between 2.31-2.45 (P < 0.0001). The excess mortality in those with S-Ca above 2.5 mmol/L was largely attributable to cardiovascular diseases (58%), although a significant excess mortality was also evident for malignant disorders (28%). In contrast, the risk of obtaining a diagnosis of malignant disease was not found to increase with rising S-Ca levels. These results indicate that the risk of premature death in men less than 50 yr of age increases with rising S-Ca, even within the normal range, and this increase may be largely due to cardiovascular diseases.

Adult↗
PubMed1998

The cost-effectiveness of a retinal photography screening program for preventing diabetic retinopathy in the First Nations diabetic population in British Columbia, Canada.

Seven-field stereo retinal photography is both 100% sensitive and specific for diagnosing diabetic retinopathy and is the standard for evaluating the severity of retinopathy both for clinical and epidemiological studies. It is also very useful for follow-up of diabetics and eventual treatment of complicated cases with laser and other treatment modalities. If the 450 First Nations diabetic cases that were surveyed in 1992 in British Columbia, Canada, were to receive an annual assessment by an ophthalmologist, the cost is estimated at $164,000 (Canadian). This amount includes travel, hotel, and meal costs of patients traveling to the ophthalmic centers in their areas and the fee for specialist services. Alternately, retinal photography screening is estimated to cost $61,000. This amount includes photo-technician labor, travel costs to the community, hotel and meal costs, ophthalmologist interpretation of the photographs, and annualized capital maintenance costs. In the first year, the cost of vehicle purchase with accessories and a camera with accessories is estimated at $61,000, with an estimated four-year lifespan of equipment. Maintenance and insurance, including vehicle fuel, will cost $12,256 annually. A retinal photography program could travel to the diabetic patient, and nearly 100% of First Nations diabetic patients could receive this service annually. This program could be highly effective in preventing blindness in First Nations diabetic patients in British Columbia through early intervention in diabetic retinopathy.

Adult↗