A retrospective study of the results of dipstick testing and microscopical examination of urine from 10 050 men undergoing health screening showed a prevalence of occult haematuria of 2-5%. Those patients with occult haematuria who were resident in the United Kingdom and registered with a general practitioner were identified and a questionnaire sent to their general practitioners asking what further investigations had been performed. The response rate was 92% (152/165 inquiries). Fifty nine general practitioners (39%) had not instigated any investigations. Among the 76 patients who underwent some further investigations abnormalities were found in 21 (28%); and among those fully investigated by examination of midstream urine, intravenous urography, and cystoscopy abnormalities were found in 12 (50%). These included bladder neoplasms (two; one in a patient aged 37), epithelial dysplasia (one), staghorn calculi (one), and chronic reflux nephropathy (one).It is proposed that occult haematuria should be fully investigated regardless of the age of the patient. IntroductionThe importance of occult haematuria as an early sign ofurinary tract disease is well known by urologists, yet it is often inadequately investigated or is accepted as a benign condition.' In younger patients haematuria most often results from urinary tract infections or disorders such as renal calculi, glomerulonephritis, or IgA nephropathy.23 Athletic haematuria is a transient phenomenon that occurs after prolonged, vigorous exercise and is unlikely to be persistent.4 In patients over 40, however, a major urinary tract lesion will be found in about 20% of those with confirmed microscopical haematuria, and in at least 10% the lesion will be malignant.' I Even when no disorder is diagnosed some patients will develop an important lesion within the next few years.5 Cancers of the urinary tract are fairly common, accounting for more than 15% of all registrations of cancer among British men.6 Furthermore, the severity of haematuria is not related to the severity of the urological lesion.5 As a carcinoma found as a result of investigating microscopical haematuria may be at an early, treatable stage it is important that haematuria detected during routine screening should be thoroughly investigated.2The development of dipstick testing has simplified the detection of occult haematuria.7 The Labstix test detects haemoglobin

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Computerized tomographic (CT) scanning of the liver was undertaken in 17 occasional and 19 heavy drinkers undergoing health screening. The median attenuation value of the liver (CT number) in occasional drinkers with normal liver function tests was 54.4 compared with 25.9 in the heavy drinkers (P less than 0.001). Fourteen of the heavy drinkers had a CT number below the lowest value observed in occasional drinkers with normal liver function, indicating reduced liver density due to fatty change. Serum gamma-glutamyl transpeptidase was normal in 36% of these individuals. A rise in CT number was observed in 4 out of 5 heavy drinkers who underwent a second scan after decreasing their alcohol consumption. These findings suggest that CT scanning provides a noninvasive and convenient method of screening for a fatty liver, which occurred to a variable degree in over 70% of the men who admitted to regularly taking 8 or more alcoholic drinks per day.

The effect of hemodialysis (HD) on blood viscosity has not been adequately investigated. We studied blood viscosity during HD employing coneplate viscometry. Ten patients with end-stage renal disease were studied before and immediately after HD. To dissect the possible effects of HD on plasma and red blood cell (RBC) determinants, we measured whole blood, plasma, and reconstituted erythrocyte viscosities. The latter consisted of RBC's suspended in a buffered saline solution (pH = 7.4 units). In addition, serum, electrolytes and hematocrit (HCT) were measured. The results revealed a significant rise in whole blood viscosity after dialysis. Likewise, plasma viscosity rose considerably with dialysis. However, when the RBC's were reconstituted to a constant HCT, no significant difference was noted before and after HD. As expected, body weight, blood urea nitrogen (BUN) and creatinine concentrations fell while HCT and protein concentration rose with HD. A significant correlation was found between the observed rise in HCT, and dialysis-induced rise in whole blood viscosity. Likewise, the observed rises in plasma viscosity after dialysis significantly correlated with the rise in protein concentration. In addition, the change in whole blood and plasma viscosity values correlated with the degree of ultrafiltration (weight loss). In conclusion, whole blood and plasma viscosity rises with hemodialysis. The observed rise in viscosity is primarily due to hemoconcentration.