Regular Medical Check-ups Research Articles

Applying sequential pattern mining to investigate cerebrovascular health outpatients' re-visit patterns.

Background and ObjectiveIncreases in outpatients seeking medical check-ups are expanding the number of health examination data records, which can be utilized for medical strategic planning and other purposes. However, because hospital visits by outpatients seeking medical check-ups are unpredictable, those patients often cannot receive optimal service due to limited facilities of hospitals. To resolve this problem, this study attempted to predict re-visit patterns of outpatients.MethodTwo-phase sequential pattern mining (SPM) and an association mining method were chosen to predict patient returns using sequential data. The data were grouped according to the outpatients’ personal information and evaluated by a discriminant analysis to check the significance of the grouping. Furthermore, SPM was employed to generate frequency patterns from each group and extract a general association pattern of return.ResultsResults of sequence patterns and association mining in this study provided valuable insights in terms of outpatients’ re-visit behaviors for regular medical check-ups. Cosine and Jaccard are two symmetric measures which were used in this study to indicate the degree of association between two variables. For instance, Jaccard values of variable abnormal blood pressure associated with an abnormal body-mass index (BMI) and/or abnormal blood sugar were respectively 47.5% and 100%, for the two-visit and three-visit behavior patterns. These results indicated that the corresponding pair of variables was more reliable when covering the three-visit behavior pattern than the two-visit behavior. Thus, appropriate preventive measures or suggestions for other medical treatments can be prepared for outpatients that have this pattern on their third visit. The higher degree of association implies that the corresponding behavior pattern might influence outpatients’ intentions to regularly seek medical check-ups concerning the risk of stroke. Furthermore, a radiology diagnosis (i.e., magnetic resonance imaging or neck vascular ultrasound) plays an important role in the association with a re-visit behavior pattern with respective 50% and 70% Cosine and Jaccard values in general behavior {f11}∧{f01}. These findings can serve as valuable information to increase the quality of medical services and marketing, by suggesting appropriate treatment for the subsequent visit after learning the behavior patterns.ConclusionsThe proposed method can provide valuable information related to outpatients’ re-visit behavior patterns based on hidden knowledge generated from sequential patterns and association mining results. For marketing purposes, medical practitioners can take behavior patterns studied in this paper into account to raise patients’ awareness of several possible medical conditions that might arise on subsequent visits and encourage them to take preventive measures or suggest other medical treatments.

Chronic pyelonephritis: dynamics of distribution, indicators on rendering the specialized medical aid to the patients of the capital and Ukraine

The work represents the results of the comparative analysis of criterions on the prevalence, morbidity in chronic pyelonephritis (CPN) among various age groups of adult population in Kyiv and Ukraine as a whole and also the main findings on rendering the specialized service to the patients in the given context. The study period was 6 years and it was divided in two periods (2011–2013 and 2014– 2016) dictated by the well known events in the country which could not but be reflected on the corresponding indicators of the last three years; clearing up of the character of changes in the whole Ukrainian scale and in Kyiv, as the Capital, is of interest from the point of view of state of health in the population and the organization on rendering medical help to the patients in one of the widespread pathologies of the urologic profile. It was found out that practically during all follow-up time the indices of prevalence and morbidity in Kyiv were lower than in the country as a whole. The specificity of changes was displayed in the growth of wide-spreadness during the first three years, which was more intensive in the Capital due to the persons of employable age but throughout the country — above the employable age. Three next years were characterized by its decreased level in Kyiv mainly among the last, preservation of dynamics in Ukraine with decrease of process intensity. As a result, in the Capital during 6 years the increase of patients of the employable age was 5.3%. In 2016 the actual data in Kyiv were the following: among the adult population – 1181,9, employable – 737,5, non-employable – 2269,7, throughout Ukraine – 1567,8; 1186,5; 2398,2 respectively ( 100 tis.). At the same time, in Kyiv morbidity grew, the growth was more intensive during 2014 – 2016, in particular among the persons of retiring age, while through the Ukraine, on the contrary, the general level decrease became slower with years. In 2016 the indicators in Kyiv were as follows: among the adult population – 91,7, employable – 60,7, non-employable – 166,5, throughout Ukraine – 127,6; 118,1; 151,5 respectively (100 tis). There was followed up negative dynamics of rendering the specialized aid to the CPN patients in Kyiv in the form of low indices of regular medical check-up, high lethality which grows with time up to 6.0% in 2016. The above-mentioned needs not only the aiming further monitoring of processes which take place in Kyiv but also performing of studies with the expert assessing of quality of diagnostics and treatment of the indicated category of patients.

CLINICAL MANIFESTATIONS OF SARCOIDOSIS ON THE PROLABIUM AND ORAL MUCOSA: MANAGEMENT

The statistics indicates on the tendency of morbidity rate of sarcoidosis to increase. The pathology affects young and older people notably. Sarcoidosis becomes a common chronic disease, which is often difficult to diagnose.
 Insufficient experience in recognition of this disease leads to misdiagnosis and ineffective treatment. All mentioned above highlights the extreme relevance of this issue.
 Sarcoidosis is a multisystem inflammatory nature disease of unknown etiology. The hereditary predisposition is taken to be but the whole family cases are also known. An abnormal immune response is also considered among the theories of the development of the disease. The infectious factor is also regarded as the cause of the disease.
 The increasing activity of lymphocytes, which start to produce substances promoting the formation of the granulomas, which are considered to be the basis for the pathological process, can initiate the onset of the disease.
 The maximum morbidity rate of sarcoidosis is observed between the ages of 35 to 55 years. Two age periods of the peak in male population are 35-40 years and about 55 years. The rate of sarcoidosis morbidity among female population is 65%. Up to 700 new cases of sarcoidosis are registered in Ukraine annually.
 The clinical signs of sarcoidosis vary. This pathology is more often manifested by the bilateral lymphadenopathy of lung roots, eyes and skin lesions. The liver, spleen, lymph nodes, heart, nervous system, muscles, bones and other organs can also be affected. In dental practice sarcoidosis can be manifested on the prolabium, oral mucosa and salivary glands.
 Blood laboratory indices (the increased level of calcium) are changed in sarcoidosis. Chest X-ray, MRI and CT also demonstrate changes in the lungs.
 The test for detection of granulomas shows positive Kveim reaction (the formation of purple-red nodules due to administration of antigen).
 Biopsy and bronchoscopy facilitate detection of both direct and indirect signs of sarcoidosis of the lungs.
 A general treatment of sarcoidosis is provided by a pulmonologist, who can assess the severity of the lesion and provide appropriate treatment. The core of treatment is based on corticosteroids. In severe cases immunosuppressors, anti-inflammatory drugs, antioxidants are prescribed.
 A dentist performs oral cavity sanation, professional hygiene. Mouth rinses with Dekasan solution, sublingual Lisobakt pills are prescribed to prevent inflammatory lesions.
 Patients with sarcoidosis are recommended to avoid solar radiation and contact with chemical and toxic substances harmful to the liver, reduction of the consumption of foods rich in calcium.
 Healthy life-style is crucial in prevention of exacerbations of sarcoidosis. In the remission period regular medical check-ups and oral cavity sanation are recommended.
 The correct diagnosis in rare diseases requires highly qualified dental professionals, the interdisciplinary approach in the diagnosing and management of patients with this pathology.

Violations of safe diving practices among 122 diver fatalities

Diving is a popular recreation with an excellent safety record, with an estimated 1.8 deaths per 1 million dives. This study investigated the relationship between intentional deviation from accepted diving practices (violations) and diver fatalities. The authors examined 119 incidents/122 diver fatalities that did not involve diver training in North America and the Caribbean, and identified the presence of violations of accepted diving safety practices, as well as if the death was associated with an acute medical event such as heart attack. Of the 122 fatalities, 57% (n = 70) were associated with a medical event and 43% (n = 52) were non-medical. Violations were found in 45% of fatalities (n = 55) overall. Violations were recorded for 23% of the 70 medical and 75% of the 52 non-medical fatalities. Divers who died from something other than a medical cause were 7 times as likely to have one or more violations associated with the fatality (OR 7.3, 95% CI 2.3-23.2). The odds of dying from something other than a medical condition increased approximately 60% for each additional 10 metres of depth. The odds of a death being associated with a medical condition increased approximately 9% per year of age, or 2.4 times for every 10 years older a diver was. Medical events are associated with over half of the non-training related diver fatalities in North America and the Caribbean, with the odds of death being associated with a medical condition doubling each decade of additional age. These data support recommendations that divers stay physically fit and have regular medical checkups, particularly as they get older. They also strongly support the safety benefit of adhering to established safe diving practices.

Emission Level of PM2.5 and its Association With Chronic Respiratory Symptoms Among Workers in Cement Industry: A Case of Mugher Cement Industry, Central Ethiopia

In Ethiopia, occupation-related respiratory symptoms are extensively increasing with the expansion of cement manufacturing industries. However, little information is available on the extent of emissions and its association with chronic respiratory diseases. This study assessed the emission level of PM2.5 and its association with chronic respiratory symptoms among workers in Mugher Cement Factory, in 2018. A cross sectional study was employed on a total of 309 cement factory workers. Air check sampler, model 224-54, was used to measure the concentration of PM2.5. Variables with P value < 0.2 during bivariate analysis were selected as candidate for multiple logistic regressions. Significance level was set at P value <0.05. A total of 309 workers participated in the study with an overall response rate of 97%. The mean age of the respondents was 32.02 years (±4.7 SD). Emission levels of all PM2.5 samples were above the allowed standard. Among the workers, 50.8% had chronic respiratory symptoms and factors associated were: working in raw material receiving unit (adjusted odds ratio [AOR]= 7.5, 95% CI, 2.9, 19.4), cement milling unit (AOR = 2.4, 95 % CI ,1.2, 4.8), packing unit (AOR= 2.2, 95% CI= 1.1, 4.3), workers’ monthly income level below 3000 ETB (AOR; 5.8, 95% CI,1.9, 17.6), and workers’ regular medical checkup (AOR = 2.4, 95 % CI, 1.0, 5.2). The concentration level of PM2.5 and prevalence of chronic respiratory symptoms were high in the study area. Use of personal protective devices and periodic monitoring of installed pollution control devices is highly recommended.

Проблема безопасности применения ортокератологии в клинической практике

In recent years, application of night orthokeratological contact lenses (OK lenses) is becoming more and more widespread the world over. Modern orthokeratology makes use of gas-permeable contact lenses of reverse geometry: these are sophisticated structures made from materials with high oxygen permeability. The change of the curvature of the external corneal surface and, as a result, ocular refraction changes caused by OK lenses occurs due to changing architectonics of the corneal epithelium. The safety of orthokeratology is a pressing issue. The percentage of revealed complications in patients wearing OK lenses is comparable to, and in some cases, is even lower than with other means of vision correction. If the choice of OK lenses is adequate and the patient wearing them complies with wearing instructions and maintenance rules, their long use does not entail clinically significant complications. The results of the study emphasize the importance of a careful choice of OK lenses and regular medical checkups of patients. For citation: Levchenko Yu.S. The safety issue of orthokeratology application in clinical practice. Russian ophthalmological journal. 2018; 11 (2): 87-94. doi: 10.21516/2072-0076-2018-11-2-87-94 (In Russian).

Regular medical checkup behaviour: preventing is better than curing

PurposeThe purpose of this paper is to investigate the factors that drive or impede the intention of Indonesian consumers to perform regular medical checkup (MCU).Design/methodology/approachThis study begins with an ethnographic study to ascertain the determinant factors that motivate or hinder an individual from performing regular MCU. The study involved stakeholders in various health services providers, including patients and medical professionals. The quantitative part of this study focuses on “preventive” segment of consumers. A survey was conducted covering 303 respondents, consisting of two sub-segments of people labelled “healthy lifestyle” and “unhealthy lifestyle”.FindingsConsumer behaviour with regards to needs for MCU must be categorised not based on demographics, but their health status – preventive or curative. The “preventive” group was found to have differences in triggers and barriers between the healthy vs unhealthy lifestyle subgroups. For the “healthy lifestyle” subgroup, the determining factors for a regular MCU are the perceived benefit of action, social deviance, and cost perception. For the “unhealthy lifestyle” subgroup, the determining factors for a regular MCU are the social deviance, disease heritage, belief in traditional medicine, no urgency and cost perception.Research limitations/implicationsThe qualitative study part indicated the differences between two segments: preventive vs curative. The quantitative study part is only conducted in the preventive segment and not covering the curative segment. It would be interesting to see the differences between these two segments.Practical implicationsImplication of study: to create contextual marketing communication in each stakeholders/segments – to reach the marketing objectives. Different segment has different issues to handle and need a different marketing communication programme.Originality/valuePrevious studies have focused on analysing the differences in groups based on their demographics, which does not illustrate a homogenous need for an MCU. This study contributes by addressing that researchers must differentiate between “preventive” and “curative” groups. Additionally, the study of triggers and barriers has interestingly found that the determinant factors for healthy and unhealthy lifestyle are not the same.

CONCEPTUAL STUDY OF ROLE OF AYURVEDA IN PREVENTION OF LIFESTYLE DISEASES

Ayurveda is the science of life, guiding in maintaining health and curing of diseases by balancing doshas-dhatus-malas and jatharagni. Ahara, nidra and brahmacharya form the pillars of health as per Ayurveda.
 Lifestyle diseases are those diseases whose occurrence is based on the daily habits of people and are a result of an inappropriate relationship of people with their environment. The main factors contributing to lifestyle diseases include bad food habits, physical inactivity and disturbed biological clock. Occupational lifestyle diseases include those caused by the factors present in the vicinity of pollutants. These factors are also responsible for environmental allergies. So, a healthy lifestyle must be adopted with a proper balanced diet, physical activity and by giving due respect to biological clock.
 Healthy lifestyle methods are now easily achievable with nutritional counselling, exercise training, de-addiction programmes, regular medical check-ups and stress management techniques. Ayurveda provides better solution in the guidelines of proper dietary management, lifestyle advises, panchakarma procedures like detoxification and bio-purification procedures, medicaments and rejuvenation therapies. In this revolutionized era, we cannot stop doing the developmental work, but we can certainly reduce our ailments with simple and effective measures in our lives as suggested in Ayurveda, the science of life.

Study to assess the socio-demographic profile, health status and working conditions of auto-rickshaw drivers in Bhopal

Background: In India auto-rickshaws are main mode of public transport in urban and areas. Health has always been closely linked with occupation. Auto drivers are exposed to harmful environment like pollutant gases, continuous noise and whole-body vibration as well harmful lifestyle like irregularity of meals, bad posture while driving and stressful occupational conditions due to their working conditions. This study was undertaken to assess the socio-demographic profile, Health status and working conditions of auto-rickshaw drivers.Methods: This cross sectional study was conducted at 15 auto-rickshaw stands of Bhopal city. 20 auto-rickshaw drivers were selected from each stand. A pre designed questionnaire was used to obtain the details of auto-rickshaw drivers. The data was entered in Ms Excel and analysed using Epi info 7.Results: The mean age of study participants was 39.17±10.38 years. 25% of study participants were educated upto 10th std while 22% participants were illiterate. 40.33% of study participants were belonging to lower middle SES. Average no. of customers per day 7, average working hours 12, average income per day on busy day Rs. 420, average income per day on dull day Rs.101. 6.67% of study participants were hypertensive, 3.67% have diabetes while 1% have both HTN and diabetes.12% participants complained of Lacrimation while driving in day.Conclusions: Our study throws some light on working condition and health status of auto-rickshaw drivers. Addiction was common among study participants. There is need for creating awareness regarding health promotion and regular medical check-up.

Impact of awareness about hypertension on compliance to antihypertensive medication

Background: Hypertension, a common cardiovascular disorder accounts for 20-50% of all deaths. This risk can be greatly ameliorated by creating awareness about disease and its effective treatment alongside regular medical check-ups. Therapeutic failures result from patient non-compliance, manifested as intentional or unintentional errors in dosage or schedule, overuse or underuse of prescribed drugs and early termination of therapy. Adherence is helpful for management of hypertension and cost minimization. Non-adherence to the drug treatment is an important factor for uncontrolled hypertension and its complications.Methods: Patients were interviewed individually after taking informed consent, using pretested, predesigned, self- administered and closed ended questionnaire both before and 4 weeks after creating awareness about hypertension and its complications. Compliance measured by self-reporting in which knowledge of the patient about number of antihypertensive drugs being used, formulations of drugs, frequency of administration, duration of taking the drugs and knowledge of complications due to uncontrolled and untreated hypertension were assigned 1 score each. Patient having score of at least 4 out of total 5 was considered compliant.Results: No significant association of compliance with demographic and other variables like age, sex, marital status, economic status, education, urbanization, duration of treatment and drug procurement were noted. A significant increase in compliance in patients on antihypertensive medication was found 4 weeks after creating awareness about hypertension and its complication. A significant increase in compliance scores was also seen in non-compliant patients showing their shifting from non-compliance to compliance group. Overall compliance increased from 59.38% to 84.38%. A percentage decrease from 58.82% to 25% in patients having uncontrolled hypertension was also observed after the awareness about hypertension.Conclusions: Demographic variables, duration of hypertension and drug procurement have no significant effect on compliance to antihypertensive medication. There is persistence and improvement in compliance to antihypertensive medications after an education of the patients about hypertension and its complications.

PP128 Relationship Between Hemoglobin A1c And Medical Costs

Introduction:Diabetes causes complications and collateral diseases, reducing quality of life and increasing medical costs. The Japanese government has promoted measures for the prevention of diabetes aggravation. Although glycemic control is reported to prevent the development of complications, assessment of the effects on overall medical cost is insufficient. We examined the medical cost by the analysis of hemoglobin A1c (HbA1c) level.Methods:A Japanese employee-based health insurance claims database with annual medical check-up data was analyzed. Excess medical cost was calculated as the difference between medical cost and standard medical cost (defined as the average medical cost for individuals of same age and sex). Percentage of excess medical cost was calculated by dividing excess medical cost by standard cost, and compared between individuals with or without treatment for diabetes.Results:Of 4,307,184 individuals with HbA1c data, four percent of them received treatment for diabetes. For treatment of 6.5 percent of HbA1c, excess medical cost increased to 124 percent. The medical cost increased by an additional 20.4 percent (95% CI: 17.1–23.8) when the HbA1c level increased one percent. Treatment for less than six percent of HbA1c caused an increase consistent with the HbA1c level. The relative risk of iron deficiency anemia, unspecified of those with less than six percent of HbA1c against those with seven to eight percent was the highest, 2.15.Conclusions:An increase of medical cost for individuals with treatment for high HbA1c is likely associated with diabetic complication. The raise for individuals with lower HbA1c level may be related to anemia. Despite the younger age and healthier life of the analyzed individuals, since they were insured by employee-based health insurance who took regular medical check-ups, more expensive medical cost was observed for those having higher HbA1c level.

The economic crisis and lifestyle changes: a survey on frequency of use of medications and of preventive and specialistic medical care, in the Marche Region (Italy).

Background and aim: In the words of one observer, one of the many effects of the economic downturn has been a “health system shock” marked by reductions in the availability of healthcare resources and increases in the demand for health services. The financial situation influences negatively the low-income family groups, particularly those who normally use the government provided primary prevention services. The goal of this study was to assess the impact of the global recession on the use of medicines and medical investigation recession in different areas of the Marche Region. Methods: An anonymous questionnaire prepared by the National Institute of Statistics, modified and validated by the University of Camerino, has been distributed to junior highschool students of Central Italy to provide a statistically representative sample of families. The questionnaire has been administered in 2016-2017. Results: This article examines the results about healthcare habits, specifically, regarding medicines and medical examinations. Data obtained emphasize a reduction in the use of nonsteroidal anti-inflammatory drugs (NSAIDs). The parents category showed the higher change in medicines use (72.9%). Comparing the data of the Fabriano area with that of the Civitanova Marche area, Fabriano reported a greater reduction in the frequency of taking medicine. Concerning the medical examinations, half of the respondents (62.5%), indicated that they and their family members have regular medical check-up. Conclusions: Respondents who admitted that the economic crisis had reduced their quality of life indicated that the parents were the ones who had experienced the greatest change. This is confirmed by the information on the reduced frequency of medicine use, which affected the parents more than the children, whom they sought to protect and safeguard the most. This reduction was most marked in the Fabriano area. In contrast, in the Civitanova Marche area, with different socioeconomic characteristics, an increase in the use of all the categories of medicines was reported. Concerning visits the situation in the Marche Region appears encouraging. (www.actabiomedica.it)

The feasibility of the early application of the means for the physical rehabilitation with a view to improvement of life quality in the women presenting with postmastectomy syndrome

the problem of rehabilitation and improvement of the life quality of women with the postmastectomy syndrome holds an important place in the modern concept of the treatment of breast cancer. The objective of the present study was to determine the purposefulness of the early application of the available means and methods of physical rehabilitation for the improvement of the life quality in the women presenting with postmastectomy syndrome. The study included 135 women with the postmastectomy syndrome who had undergone radical mastectomy as described by Madden followed by postoperative radiotherapy. Fifty women were examined and treated as in-patients whereas the remaining 85 ones were out-patients under regular medical check-up The average age of the treated patients was 60.27±0.79 years. The in-patients were randomly subdivided into two groups: the main one (n=25) and the group of comparison (n=25). At the stage of dispensary observations, the women were also allocated to two groups: the first (n=45) and the second main groups (n=40), depending on the choice of the personality-oriented program for physical rehabilitation. The analysis of the quality of life was carried out in the beginning of the out-patient rehabilitation treatment, then within 6 and 12 months after its initiation making use of the standardized Functional Assessment of Cancer Therapy (FACT-B + 4) questionnaire. The benefits of the early physical rehabilitation of the in-patients first became apparent within six months after the onset of training as follows from the significantly better performance of the physical, social, emotional functions estimated taking into consideration the subscales of breast cancer and hand disorders in the women comprising the main group of the patients in comparison with those in the first and second main groups: the difference amounted to 2.34 (p<0.05), 1,88 (р<0.01), 2,52 (р<0.001), 3,52 (р<0.001) and 4,09 (р<0.001) points respectively. In a year, only the improvement of the social and emotional state persisted. The proposed personality-oriented program of physical rehabilitation can be used in the clinical practice of the relevant specialized departments for the improvement of the quality of life of the women presenting with postmastectomy syndrome.

The incidence and risk factors of asymptomatic primary spontaneous pneumothorax detected during health check-ups

BackgroundPatients with primary spontaneous pneumothorax (PSP) usually complain of sudden-onset dyspnea and pleuritic chest pain. However, asymptomatic PSP has been incidentally detected on chest X-rays. In this study, we analyzed the incidence, characteristics, risk factors, and prognosis of asymptomatic PSP detected during regular medical check-ups in university students.MethodsIn this study, 101,709 chest X-rays were performed during medical check-ups for students at the University of Tokyo between April 2011 and March 2016. Among them, 43 cases of asymptomatic PSP (0.042%) were detected. We calculated the lung collapse rate of pneumothorax using Kircher’s method. We also analyzed risk factors associated with asymptomatic PSP using characteristics inspected in medical check-ups.ResultsThe incidence of asymptomatic PSP was significantly higher in men than in women (0.050% vs 0.018%). Multivariate analysis revealed an association of younger age, greater height, lower body mass index, and greater height growth per year with an increased risk of asymptomatic PSP in male students. Mild lung collapse (<10%) was present in 22 of 43 students with asymptomatic PSP; among these, eight students eventually underwent an invasive therapy.ConclusionsThe prevalence of asymptomatic PSP among university students was as high as 0.042%. In addition to known risk factors for conventional PSP, greater height growth was a risk factor for asymptomatic PSP. Careful follow-up is very important because a considerable number of patients with mild lung collapse eventually require an invasive medical procedure.

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

Identifying health conditions, priorities, and relevant multilevel health promotion intervention strategies in African American churches: A faith community health needs assessment

Attention to elderly individuals with hypertension: the Brazilian National Health Survey , 2013

This study aimed to assess the attention paid by health professionals to elderly individuals with hypertension and related inequalities in Brazil, using level of schooling as the socioeconomic indicator. This was a cross-sectional study with data from the Brazilian National Health Survey, 2013. Attention was assessed according to the following indicators: recommendations for healthy eating, maintaining adequate weight, less salt, regular exercise, prevention of smoking and excessive drinking, and regular medical checkups with blood and urine tests, ECG, and stress test. The recommendations to consume less salt (91%), healthy diet (88%), and regular medical checkups (88%) were the most common. Elderly with complete university degrees showed the highest prevalence rates for recommendations to maintain a healthy diet (PR = 1.12), adequate weight (PR = 1.21), regular exercise (PR = 1.29), regular medical checkups (PR = 1.11), and stress test (PR = 2.26) and all the indicators combined (PR = 2.14) when compared to elderly without schooling. The attention paid to the elderly by health professionals is suboptimal throughout the country. In addition, inequalities in attention to the elderly's needs still persist. Given the growth in the elderly population and chronic non-communicable diseases, efforts are needed to improve the quality of their care and mitigate the related inequalities.

Determination of Trace Metal Levels in the General Population of Korea.

The purpose of this study was to determine the levels of trace metals in the blood of the general Korean population. A total of 258 healthy individuals, according to their regular medical check-ups, (119 males and 139 females, age ranging from 12 to 78 years old) were enrolled from December 2014 to December 2016. Levels of 10 trace elements were determined using inductively coupled plasma mass spectrometry (ICP-MS). The geometric mean (GM) levels for lead, arsenic, cesium, mercury, aluminum, cadmium, copper, manganese, selenium, and zinc were 15.97 μg/L, 7.19 μg/L, 2.39 μg/L, 3.41 μg/L, 10.57 μg/L, 0.78 μg/L, 979.8 μg/L, 11.06 μg/L, 111.37 μg/L, and 872.7 μg/L, respectively. There were significant gender-related differences in the levels of several metals; male individuals had higher Pb, As, Cs, Hg, and Se than females, while females had higher Cd, Cu, and Mn than males. We noticed remarkably high blood levels of Hg, As and Al in the Korean population. The element concentrations reported represent a new contribution to the knowledge of the blood chemistry for the Korea population. The data can be used to assess the clinical health of this population.

THE CLINICAL AND X-RAY FEATURES OF PULMONARYMYCOBACTERIOSIS

The morbidity rate of pulmonary mycobacteriosis is growing in the Republic of Belarus, which requires the study of the disease aimed at the improvement of the diagnostics, treatment and regular medical check-up of patients. We retrospectively studied 62 cases of pulmonary mycobacteriosis in patients observed in 2010-2016. It has been found that non-specificity of the clinical and roentgenological picture of mycobacterioses leads to diagnostic difficulties. The most reliable verifying method is multiple detecting and identification of non-tuberculous mycobacteria by cultivation. The etiotropic treatment of the patients must be provided taking into account the individual sensitivity of an agent to antibacterial medicinal drugs.

Langerhans Cell Histiocytosis Mimicking Aggressive Periodontitis. A Multidisciplinary Approach During an 8‐Year Follow‐Up Period

Introduction: Aggressive periodontitis (AgP), according to the diagnostic criteria set by the American Academy of Periodontology, is an infrequent periodontal disease. However, certain cases originally diagnosed as AgP due to young age and the involvement of first molars, when not responding to therapy, can diagnostically involve more severe systemic conditions such as the rare disorder Langerhans cell histiocytosis (LCH).Case Presentation: A 25‐year‐old white male, with no known systemic diseases, was referred to the Postgraduate Clinic of the Department of Periodontology and Implant Biology, Dental School, Aristotle University of Thessaloniki, Thessaloniki, Greece. Clinical and radiographic examination and comparison with a previous evaluation revealed a rapidly progressive lesion involving the molar region in all quadrants, although the patient had been treated by a periodontist during the last 2 years. Molars were extracted and biopsies taken, which demonstrated morphologic and immunohistochemical characteristics leading to the diagnosis of LCH. The patient was referred to a hematology clinic, where he received a comprehensive examination and chemotherapy. The patient did not further comply with his proposed medical treatment and therefore 2 years later appeared with a progressing lesion in the molar area. He was re‐treated by further extractions and closure of a sinus perforation. He was persuaded to continue the treatment plan and received supportive periodontal treatment every 3 months. Regular medical and periodontal checkups show that his condition remains stable during the last 5 years.Conclusion: Periodontists should be aware of rare systemic conditions mimicking AgP and immediately refer the patient accordingly.

Phenotype analysis of lymphocytes in workers with chronic benzene exposure

Background Automobile service station workers are at high risk of benzene toxicity because they neither take protective measures to prevent inhalation of petroleum products nor undergo regular medical checkup. Objective The aim of this paper was to study the effects of long-term benzene exposure on blood cells and liver function. Patients and methods The study was a controlled trial, which included 30 automobile service station workers investigated for alterations in blood cells, hepatic functions, and lymphocyte phenotype. Results When compared with controls, benzene-exposed workers had significant increase in alanine aminotransferase (47.80±3.19 vs. 28.50±4.35), aspartate aminotransferase (41.20±2.62 vs. 23.60±4.58), and alkaline phosphatase (305.13± 16.39 vs. 174.40±26.69) levels and significant decrease in total proteins (6.39±0.11 vs. 6.79±0.12), albumin (3.57±0.14 vs. 4.5±0.48), hemoglobin (10.77±0.49 vs. 13.97±0.69), platelets count (146.8±4.9 vs. 217.8±37.4), mean platelet volume (7.68±0.4; 8.83±0.8), white blood cells (3459±444 vs. 6171±1482), monocytes (188±64 vs. 338±190), neutrophils (2095±267 vs. 3487±998), lymphocytes (1177±265 vs. 2138±439) and its subsets [CD3 cells (948±217 vs. 1686±337), CD4 cells (321±81 vs. 1101±222), B cells (228±70 vs. 45.1±13.22), and CD4 : CD8 ratio (0.51±0.04 vs. 1.88±0.08)], with significant increase in CD8 cells (627±138 vs. 585±117) and platelet-lymphocyte ratio (PLR) (130.7±26.66 vs. 104.96±22.49). The duration of exposure positively correlated with PLR and negatively correlated with hemoglobin, platelets, mean platelet volume, white blood cells, neutrophil, lymphocyte (B cells, helper cells, and suppressor cells), and serum albumin. PLR had a negative correlation with CD4, CD8, and CD19 absolute counts. Conclusion Benzene exposure is detrimental to the liver and bone marrow and results in the reduction of all blood and lymphocyte series, intiating immune suppression which may predispose to carcinogenesis. PLR is a valuable, inexpensive, and reproducible index that is closely associated with impaired immune system in benzene-exposed workers.