scholarly journals Association and Predictive Value Analysis for Resting Heart Rate and Diabetes Mellitus on Cardiovascular Autonomic Neuropathy in General Population

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Zi-Hui Tang ◽  
Fangfang Zeng ◽  
Zhongtao Li ◽  
Linuo Zhou

Background.The purpose of this study was to evaluate the predictive value of DM and resting HR on CAN in a large sample derived from a Chinese population.Materials and Methods.We conducted a large-scale, population-based, cross-sectional study to explore the relationships of CAN with DM and resting HR. A total of 387 subjects were diagnosed with CAN in our dataset. The associations of CAN with DM and resting HR were assessed by a multivariate logistic regression (MLR) analysis (using subjects without CAN as a reference group) after controlling for potential confounding factors. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the predictive performance of resting HR and DM.Results.A tendency toward increased CAN prevalence with increasing resting HR was reported (Pfor trend<0.001). MLR analysis showed that DM and resting HR were very significantly and independently associated with CAN (P<0.001for both). Resting HR alone or combined with DM (DM-HR) both strongly predicted CAN (AUC = 0.719, 95% CI 0.690–0.748 for resting HR and AUC = 0.738, 95% CI 0.710–0.766 for DM-HR).Conclusion.Our findings signify that resting HR and DM-HR have a high value in predicting CAN in the general population.

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiongyan Wu ◽  
Lingfang Wang ◽  
Xiumin Zhao ◽  
Qifang Tian ◽  
Fenfen Wang ◽  
...  

PurposeThis study aims to validate the value of microRNA (miRNA) detection for triaging human papillomavirus (HPV)-positive women in the general population.Patients and MethodsmiR-375 detection in cervical exfoliated cells has been demonstrated to have the superior value to cytology in triaging primary HPV-positive women in the hospital population. In this study, residual samples of cervical exfoliated cells from 10,951 women in a general population were used to detect miRNA. The performance efficiency of miRNA detection in identifying high-grade cervical intraepithelial neoplasia (CIN) was evaluated. Pearson chi-square test and McNemar pairing test were used to compare miRNA detection and cytology.ResultsIn valid 9,972 women aged 25–65, miR-375 expression showed a downward trend along with an increase in cervical lesion severity. The expression level of miR-375 ≤1.0 × 10-3 was identified as positive. In the HPV-positive and 12 HPV genotypes other than 16/18 (HR12)-positive women, miR-375 detection showed equivalent sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to that of cytology (≥ASC-US) and higher or similar sensitivity and NPV but lower specificity and PPV than that of cytology (≥ASC-H) in identifying CIN3+ and CIN2+. In HPV 16-positive women, miR-375 positivity had higher sensitivity and NPV but lower specificity and PPV than that of cytology (≥ASC-H and HSIL) in identifying CIN3+ and CIN2+. The immediate CIN3+ risk of miR-375 positivity was 19.8% (61/308) in HPV-positive, 10.8% (22/204) in HR12-positive, and 43.5% (37/85) in HPV16-positive women, respectively.ConclusionThe detection of miR-375 in cervical exfoliated cells may be an optional method for triaging primary HPV-positive women in population-based cervical cancer screening.


Author(s):  
Ignatios Ioakeim-Skoufa ◽  
Beatriz Poblador-Plou ◽  
Jonás Carmona-Pírez ◽  
Jesús Díez-Manglano ◽  
Rokas Navickas ◽  
...  

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.


Author(s):  
Kevin L. Schwartz ◽  
Camille Achonu ◽  
Sarah A. Buchan ◽  
Kevin A. Brown ◽  
Brenda Lee ◽  
...  

AbstractImportanceProtecting healthcare workers (HCWs) from COVID-19 is a priority to maintain a safe and functioning healthcare system. The risk of transmitting COVID-19 to family members is a source of stress for many.ObjectiveTo describe and compare HCW and non-HCW COVID-19 cases in Ontario, Canada, as well as the frequency of COVID-19 among HCWs’ household members.Design, Setting, and ParticipantsUsing reportable disease data at Public Health Ontario which captures all COVID-19 cases in Ontario, Canada, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with COVID-19 as of 14 May 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address.Exposures and OutcomesWe contrasted age, gender, comorbidities, clinical presentation (including asymptomatic and presymptomatic), exposure histories including nosocomial transmission, and clinical outcomes between HCWs and non-HCWs with confirmed COVID-19.ResultsThere were 4,230 (17.5%) HCW COVID-19 cases in Ontario, of whom 20.2% were nurses, 2.3% were physicians, and the remaining 77.4% other specialties. HCWs were more likely to be between 30-60 years of age and female. HCWs were more likely to present asymptomatically (8.1% versus 7.0%, p=0.010) or with atypical symptoms (17.8% versus 10.5%, p<0.001). The mortality among HCWs was 0.2% compared to 10.5% of non-HCWs. HCWs commonly had exposures to a confirmed case or outbreak (74.1%), however only 3.1% were confirmed to be nosocomial. The rate of new infections was 5.5 times higher in HCWs than non-HCWs, but mirrored the epidemic curve. We identified 391 (9.8%) probable secondary household transmissions and 143 (3.6%) acquisitions. Children < 19 years comprised 14.6% of secondary cases compared to only 4.2% of the primary cases.Conclusions and RelevanceHCWs represent a disproportionate number of COVID-19 cases in Ontario but with low confirmed numbers of nosocomial transmission. The data support substantial testing bias and under-ascertainment of general population cases. Protecting HCWs through appropriate personal protective equipment and physical distancing from colleagues is paramount.Key PointsQuestionWhat are the differences between healthcare workers and non-healthcare workers with COVID-19?FindingsIn this population-based cross-sectional study there were 4,230 healthcare workers comprising 17.5% of COVID-19 cases. Healthcare workers were diagnosed with COVID-19 at a rate 5.5 times higher than the general population with 0.8% of all healthcare workers, compared to 0.1% of non-healthcare workers.MeaningHigh healthcare worker COVID-19 burden highlights the importance of physical distancing from colleagues, appropriate personal protective equipment, as well as likely substantial testing bias and under-ascertainment of COVID-19 in the general population.


BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e032993 ◽  
Author(s):  
Chunhuan Lao ◽  
David Lees ◽  
Sandeep Patel ◽  
Douglas White ◽  
Ross Lawrenson

ObjectivesTo (1) explore the regional and ethnic differences in rates of publicly funded osteoarthritis-associated hip and knee replacement surgeries and (2) investigate the mortality after surgery.DesignPopulation-based, retrospective, cross-sectional study.SettingGeneral population in New Zealand.ParticipantsPatients with osteoarthritis who underwent publicly funded primary hip and knee replacement surgeries in 2005–2017. Patients aged 14–99 years were included.Primary and secondary outcome measuresAge-standardised rate, standardised mortality ratio (SMR) and 30 days, 90 days and 1 year mortality.ResultsWe identified 53 439 primary hip replacements and 50 072 primary knee replacements with a diagnosis of osteoarthritis. The number and age-standardised rates of hip and knee replacements increased over time. Māori had the highest age-standardised rate of hip replacements, followed by European/others and Pacific, and Asian had the lowest rate. Pacific had the highest age-standardised rate of knee replacements, followed by Māori and European/others, and Asian had the lowest rate. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. The SMRs of patients undergoing hip and knee replacements were lower than the general population: 0.92 (95% CI 0.89 to 0.95) for hip and 0.79 (95% CI 0.76 to 0.82) for knee. The SMRs were decreasing over time. The patterns of 30 days, 90 days and 1 year mortality were similar to the SMR.ConclusionsThe numbers of publicly funded osteoarthritis-associated primary hip and knee replacements are steadily increasing. Māori people had the highest age-standardised rate of hip replacements and Pacific people had the highest rate of knee replacements. The Northern Health Network had the lowest rate of hip surgeries, and the Southern Health Network had the lowest rate of knee surgeries. Compared with the general population, patients who had hip and knee replacements have a better life expectancy.


2015 ◽  
Vol 49 (3) ◽  
pp. 440-449 ◽  
Author(s):  
Fernanda Mateus Queiroz Schmidt ◽  
Vera Lúcia Conceição de Gouveia Santos ◽  
Rita de Cássia Domansky ◽  
Elaine Barros ◽  
Mariana Alves Bandeira ◽  
...  

OBJECTIVE To estimate the prevalence of self-reported constipation and associated factors in the general population of a Brazilian city. METHOD Secondary analysis of an epidemiological study, population-based, cross-sectional study, about bowel habits of Brazilian population. A total of 2,162 individuals were interviewed using two instruments: sociodemographic data and the adapted and validated Brazilian version of the "Bowel Function in the Community" tool. RESULTS There was a prevalence of 25.2% for the self-reported constipation, 37.2% among women and 10.2% among men. Stroke and old age were associated with constipation in the three statistical models used. CONCLUSION The prevalence found showed to be similar to the findings in the literature, although some associated factors obtained here have never been investigated.


2014 ◽  
Vol 56 (2) ◽  
pp. 146 ◽  
Author(s):  
Gustavo José Mora-García ◽  
Doris Gómez-Camargo ◽  
Enrique Mazenett ◽  
Ángelo Alario ◽  
Álvaro Fortich ◽  
...  

Objective. To estimate anthropometric parameters’ (APs) cut-off points and association for metabolic syndrome (MetS). Materials and methods. A cross-sectional study was car­ried out with a total of 434 adult women from Cartagena de Indias, Colombia, in 2012. APs measured were waist circumference (WC), body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR) and waist-height ratio (WHtR). Cut-off points were estimated by a receiver op­erating characteristic curve (ROC). Logistic regression was applied to estimate possible associations. Results. Cut-off points for WC, BMI, BAI, WHR and WHtR were 85 cm, 28 kg/m2, 39%, 0.80 and 56, respectively. Only WHtR was associated to MetS (OR=1.11, CI95% [1.07-1.15]). Conclu­sion. WC cut-off point was higher than those proposed for Latin-American women by the Joint Interim Statement (JIS). WHtR had a low predictive value for MetS.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maryam Hassanzad ◽  
Arda Kiani ◽  
Atefeh Abedini ◽  
Hoseinali Ghaffaripour ◽  
Habib Emami ◽  
...  

Abstract Background High-resolution computed tomography (HRCT) is the gold standard for the evaluation of cystic fibrosis (CF) lung disease; however, lung ultrasound (LUS) is being increasingly used for the assessment of lung in these patients due to its lower cost, availability, and lack of irradiation. We aimed to determine the diagnostic performance of LUS for the evaluation of CF pulmonary exacerbation. Methods This cross-sectional study included patients with CF pulmonary exacerbation admitted to Masih Daneshvari Hospital, Tehran, Iran, from March 21, 2020 to March 20, 2021. Age, gender, and body mass index (BMI) of the patients were recorded. All patients underwent chest X-ray (CXR), HRCT, and LUS on admission. Pleural thickening, atelectasis, air bronchogram, B-line, and consolidation were noted in LUS and then compared with the corresponding findings in CXR and HRCT. Taking HRCT findings as reference, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy (DA) of LUS and CXR for the detection of each pulmonary abnormality were determined. Results Of the 30 patients included in this study, with a mean age of 19.62 ± 5.53 years, 14 (46.7%) were male. Of the 15 patients aged 2–20 years, BMI was below the 5th percentile in 10 (66.7%), within the 5–10 percentiles in 1 (6.7%), 10–25 percentiles in 3 (20%), and 25-50 percentiles in 1 (6.7%). The mean BMI for 15 patients > 20 years was 18.03 ± 2.53 kg/m2. LUS had better diagnostic performance compared to CXR for the detection of air bronchogram, consolidation, and pleural thickening (area under the receiver operating characteristic curve [AUROC]: 0.966 vs. 0.483, 0.900 vs. 0.575, and 0.656 vs. 0.531, respectively). Also, LUS was 100% and 96.7% specific for the diagnosis of pleural effusion and atelectasis, respectively. Conclusions LUS appears to be superior to CXR and comparable with HRCT for the evaluation of CF pulmonary exacerbation, especially in terms of air bronchogram and consolidation detection. LUS can be used to lengthen the HRCT evaluation intervals in this regard or utilized along with HRCT for better evaluation of CF pulmonary exacerbation.


2020 ◽  
Vol 8 (T1) ◽  
pp. 451-458
Author(s):  
Kholisotul Hikmah ◽  
Lucky Prisandy ◽  
Gea Melinda ◽  
M. Ibraar Ayatullah

BACKGROUND: Indonesia, the world’s fourth-most populous country, is grappling with coronavirus disease 2019 (COVID-19) catastrophe as cases continue to rise. This situation induces uncertainties and changes in daily life, leading to uneasiness among the population, which may trigger anxiety symptoms. AIM: This study aimed to analyze the factors associated with the anxiety level among the general population during the COVID-19 pandemic in Indonesia. METHODS: A cross-sectional study was carried out among 267 adults from June 10, 2020, to June 15, 2020, the transition phase week after Large-scale Social Restriction of Indonesia. The survey was conducted online using a Google Form distributed through social media (WhatsApp, Instagram, Facebook, and Twitter). Respondents over 18 years old, who agreed to participate in this study, were asked to complete the questionnaire by clicking the link. The anxiety level was measured by the Hamilton Anxiety Rating Scale. RESULTS: The results of this study showed a significant correlation between age (p = 0.010), education (p = 0.039), personal income (p = 0.034), media exposure (p < 0.01), physical activity (p < 0.01), and anxiety diagnosis (p < 0.01) with the anxiety level among general people. However, ordinal logistics regression revealed that only respondents living in the city (odds ratio [OR] = 2.476) and people with clinician-anxiety diagnosis (OR = 5.116) were more likely to experience anxiety symptoms during the COVID-19 pandemic in Indonesia. CONCLUSION: According to the obtained results, age, education level, average income per month, media exposure, physical activity, and anxiety diagnosis correlated with anxiety incidence, whereas risk factors of anxiety included current residence and anxiety diagnosis.


BMJ Open ◽  
2017 ◽  
Vol 7 (10) ◽  
pp. e017620 ◽  
Author(s):  
Sandra Elnegaard ◽  
Rikke Sand Andersen ◽  
Anette Fischer Pedersen ◽  
Dorte Ejg Jarbøl

ObjectiveTo describe patterns of disclosure of symptoms experienced among people in the general population to persons in their personal and/or professional network.DesignA population-based cross-sectional study. Data were collected from a web-based survey.SettingThe general population in Denmark.Participants100 000 individuals randomly selected, representative of the adult Danish population aged ≥20 years were invited. Approximately 5% were not eligible for inclusion. 49 706 (men=23 240; women=26 466) of 95 253 eligible individuals completed the questionnaire; yielding a response rate of 52.2%. Individuals completing all questions regarding social network relations form the study base (n=44 313).Primary and secondary outcome measuresActivation of personal and/or professional relations when experiencing a symptom.ResultsThe 44 313 individuals reported in total 260 079 symptom experiences within the last 4 weeks. No professional network relation was used in two-thirds of all reported symptoms. The general practitioner (GP) was the most frequently reported professional relation activated (22.5%). People reporting to have available personal relations were slightly less inclined to contact the GP (21.9%) when experiencing a symptom compared with people with no reported personal relations (26.8%). The most commonly activated personal relations were spouse/partner (56.4%) and friend (19.6%). More than a quarter of all reported symptom experiences was not shared with anyone, personal nor professional. The symptom experiences with the lowest frequency of network activation were symptoms such as black stool, constipation, change in stool texture and frequent urination.ConclusionThis study emphasises variation in the activation of network relations when experiencing a symptom. Symptoms were shared with both personal and professional relations, but different patterns of disclosures were discovered. For symptoms derived from the urogenital or colorectal region, the use of both personal and professional relations was relatively small, which might indicate reticence to involve other people when experiencing symptoms of that nature.


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