GENERAL INFORMATION

In 1900 George M. Gould, in a conference to the members of American Medical Association, proposed the periodic examination of the health to increase the quality of life. With the time the population has become popular between, but there is little information that demonstrate his efficacy. Recently reviews have been realized in several areas with the target to improve the performance in certain illnesses with diverse results and in the majority with scarce profitability cost / benefit.

The conditions of utility of a preventive examination must be:

• The process to prepare debit of having a significant effect on the quality of life or the duration of the same one.
• The treatment method must be acceptable.
• The process / illness must have an asymptomatic period in which his detection and treatment improves the morbidity or the mortality.
• The treatment in the asymptomatic phase must be of results superior to the obtained one in more advanced phases of the process.
• The study methods to detect some process in asymptomatic phase must be acceptable and from easy access at an accessible price.
• The incidence of the process / illness must justify a wide study in the population.

In 1979 Canadian Task Force on the Periodic Health Examination (CTF) published with these premises 78 potentially foreseeable illnesses.

There are other groups of work in this one area (FRAME, ACS, USPSTF) and there is needed the recommendation of at least 2 groups of work to justify the achievement of an examination of precocious detection of some illness. Also every individual, in accordance with the presence of certain illnesses of familiar tendency, must apply the corresponding variables.

The attempts of educating the population in certain areas debate topic is since, in some occasions, there are some occasions, there is an excessive sensation of illness (self-examination of breasts) and in others an indiscriminate increase of unimportant consultations to the doctors.

RECOMMENDATIONS, FOR GROUPS OF WORK

Reflected groups of work:

• Protocol: Summary of the FRAME (USA).
• CTF: Canadian Task Force on the Periodic Health Examination.
• Cancer Society.
• USPSTF: Group of work on prevention of illnesses of USA.

INDICATIONS

PHYSICAL EXAMINATION

• Measurement of the arterial Tension

1. Protocol: Every 2 years.
2. CTF: every 5 years or in every visit to the doctor up to 64 years and every 2 years from the 65.
3. USPSTF: Periodically.

Periodic breasts examination

1. Protocol: Advisable every 2 years up to 50 years. Later every year.
2. CTF: Annually from 50 years.
3. ACS: every 3 years between 20 and 40 years. Later annually.
4. USPSTF: Annually from 40 years.

Vaginal gynecological examination (vaginal tact)

1. Protocol: Not recommended.
2. CTF: it does not include it.
3. ACS: Every 1 to 3 years with Papanicolau up to 40 years. Later annually.
4. USPSTF: When one comes to gynecologist's consultation.

Rectal examination (rectal tact)

1. Protocol: Not recommended
2. CTF: Insufficient evidence to indicate a recommendation so much for the cancer colorrectal as for of prstata.ó
3. ACS: Annually from 40 years.
4. USPSTF: Insufficient evidence to indicate a recommendation so much for the cancer colorrectal as for that of prostate.

Control of weight and size

1. Protocol: Every 4 years.
2. CTF: Not contemplated.
3. USPSTF: Periodically

Measurement of visual keenness

1. Protocol: Not checked.
2. CTF: Insufficient evidence to indicate a recommendation in favor or against this control.
3. USPSTF: It can be useful in the elders.

Audition examination

1. Protocol: Not checked
2. CTF: Recommended in visits for other reasons.
3. USPSTF: Recommended in elders.

OTHER EXPLORATIONS.

American Cancer Society recommends a screening of cancer of thyroid gland, testicles, ganglions, oral cavity and skin every 3 years in persons from 20 to 40 years and, later, annually.

Canadian Task Force recommends clinical exploratory examination of hipotiroidismo every 2 years in the women postmenopasicasú

ANALYSIS

• Secret blood in dregs

1. Protocol: Every 2 years between 40-50 years. Later every year.
2. CTF: Not in 40-year-old minors. Information insufficiency in major than 40 years.
3. ACS: Annually from 50 years.
4. USPSTF: There is no utility evidence.

Papanicolau

1. Protocol: From the beginning of the sexual activity 2 captures in 2 years during the first 2 years, from 70 years every 2 years.
2. CTF: From the beginning of the sexual activity 2 captures in 2 years during the first 2 years. Later every 3 years up to 35 years and later every 5 years up to 74 years.
3. ACS: From the beginning of the sexual activity or from 18 years 1 capture annually for 3 years, later to criterion of the gynecologist.
4. USPSTF: From the beginning of the sexual activity or from 18 years 1 capture at first. Later every 1 to 3 years up to 65 years.

Mamografía

1. Protocol: Annually from 50 years.
2. CTF: Annually from 50 years.
3. ACS: Every 2 years between 40-49 years later every year.
4. USPSTF: Every 2 years between the 50 - 75 years.

Determination of the cholesterol in blood.

1. Protocol: Every year up to 70 years.
2. CTF: It is recommended 1 time in the men between 35-49 years of age.
3. USPSTF: It is recommended in men of medium age.

Rectum - Sigmoidoscopía

1. Protocol: Not recommended.
2. CTF: There is no information in favor or against his utility.
3. ACS: Every 3 to 5 years from 50 years.
4. USPSTF: There is no information in favor or against his utility.

Test of thyroid function

1. Protocol: Not recommended
2. CTF: There is no information in favor or against his utility.
3. USPSTF: It can be useful in major women.

Determination of specific prostate antigen.

1. Protocol: Not checked.
2. CTF: Not recommended.
3. ACS: Annually in men older than 50 years.

USPSTF: Not recommended.

• Cytology and blood in urine

1. Protocol: Not recommended.
2. CTF: Not recommended
3. ACS: Not checked.
4. USPSTF: It can be useful in men older than 70 years.

IMMUNIZATIONS

• Diftero - tetanic

1. Protocol: Every 10 years I remember after the beginning.
2. CTF: Every 10 years I remember after the beginning.
3. USPSTF: Every 10 years I remember after the beginning.

Flu

1. Protocol: Not recommended of routine.
2. CTF: Annually from 65 years.
3. USPSTF: Annually from 65 years.

German measles

1. Protocol: In not pregnant women and in age of being able to have children.
2. CTF: In not pregnant women and in age of being able to have children.
3. USPSTF: In not pregnant women and in age of being able to have children.

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