The significance of a screening test for anemia in the elderly in the health check-up

本研究は, 地域で生活する高齢者の健康診査での貧血検査の必要性と高齢者の貧血の判断基準について検討を行った. 対象は老人保健法に基づく基本健康診査を受診した40歳以上男性362名, 女性621名である. 貧血検査の結果より, 造血機能は男女とも70歳代以降から有意に低下し, また加齢にともない個人差が大きくなっていた. 貧血は高齢者の活動性を維持した社会生活を送るための指標として重要な項目である. 貧血症状を鑑別しにくい高齢者にとっては血液学的検査が有効であり, 健康診査で高齢者に貧血検査を実施することは, 二次性の貧血の早期発見に加え, 加齢による経年的変化をふまえ個々にあった生活指導に活用することができ, 意義が大きいと考える. また, 地方の一地域で生活する住民を対象とした貧血検査から得られた結果ではあるが, 65歳以上の高齢者の貧血のスクリーニングの基準値の一例として, 性別のヘモグロビン濃度の(平均値-標準偏差)を正常範囲最小値とし, 男性13.1g/dl, 女性11.8g/dlを提案したい.The purpose of this study is to grasp the actual conditions of anemia in the elderly who live in the community, to examine the criteria for anemia in the elderly as a screening level in the health check-up, and to discuss the necessity of anemia screening in the elderly. The research subjects were 362 men and 621 women over 40 years of age, who took the annual health check-up prescribed in the law for welfare of the elderly. As the criteria for anemia, it is proposed that the reference values for hemoglobin should be 13.1 g/dl for men and 11.8 g/dl for women, according to the average values of hemoglobin for persons over 65 years of age with their standard deviations (14.4 ± 1.27 g/dl for men, 13.1 ± 1.23 g/dl for women). The early detection of anemia in the elderly is crucial, because the main cause of secondary anemia in the elderly is the bleeding in the gastrointestinal organs. However, it is difficult for the elderly to detect their own anemic condition, by either subjective symptoms or inspection. Blood testing is an effective means of screening anemia, and it is recommended that an anemia inspection is carried out every year in the annual health check-up

Calculating Organ Doses of Patients in Spiral CT Using EGS4 Monte-Carlo Simulation of Voxel Phantom

The doses of patients on X-ray CT imaging are higher than other general X-ray diagnoses. On the view point of radiation protection, the optimizations of X-ray CT imaging are very important. However, it is not easy to estimate patients\\u27 doses by direct measurements using dosemeters. We have calculated the patients\\u27 doses by the method of Monte-Carlo simulations. The mathematical phantom used in the simulations was a voxel phantom of a Japanese male, which have been developed in JAERI. It was based on the pictures of X-ray CT scanning for the whole body, and constructed of about 6.63 million voxels. The simulation code was EGS4, and the fortran compiler was g77 in a Pentium IV PC Linux machine. The geometry of the voxel phantom was included in the EGS4 user code. The material data of the voxels were soft tissue, lungs and bone data of ORNL. As the X-ray spectra with filters for each tube voltages, Birch\\u27s data were referred in the user code. For X-ray CT imaging conditions of calculations, some typical X-ray CT diagnoses were selected. As photon irradiation parameters, the exposure area, slice number, slice width and X-ray tube voltages were set. The center axis and X-ray tube focus positions were determined based on a real X-ray CT machine geometry. The energy depositions of organs were calculated, and patients\\u27 doses were estimated. The ratios of entrance surface dose and each organ doses can be obtained and used for the estimation of the doses. They are useful as indicators for the consideration of optimization on X-ray CT imaging in practice.11th International Congress of the International Radiation Protection Associatio