Prevalence and risk factors of gallbladder polyps in primary health care centers among patients examined by abdominal ultrasonography in Qatar: a case–control study

Background: Gallbladder (GB) polyps are raised lesions from the GB wall and projected into its lumen. The prevalence of GB polyps ranged between 4.3% and 12.3%. The clinical presentation of GB polypoid lesions vary, can be nonspecific and vague, and may be asymptomatic. Identifying malignant and premalignant polyps is important to provide treatment early and prevent cancer spread or development of malignancy. Ultrasonography (US) is the first imaging modality widely used in abdominal imaging. It is a noninvasive, rapid, painless, and safe imaging technique, with no radiation; thus, it is considered the best available examination with good sensitivity and specificity for GB polyps. Aim of the work: This study aimed to determine the relative frequency of the GB polyps and its risk factors among patients who underwent abdominal US in Primary Health Care Corporation, Qatar. Materials and methods: This was quantitative multicenter observational case–control study nested in a cross-sectional design. For the cross-sectional top-level study, the first step was to assess available abdominal ultrasound studies for the presence of GB polyps and stones. The second step was to perform a case–control study with three groups (a case group and two control groups; first, participants without GB stones and GB polyps; second, patients with GB stones but without GB polyps). Results: The study evaluated the GB images of 7156 individuals. The overall prevalence of GB polyps was 7.4% in the study population. Specifically, the overall prevalence of solitary GB polyp was 4.2% and that of multiple GB polyps was 3.2%. Regarding the size distribution of GB polyps in positive cases, 89.4% were < 6 mm, 9.3% were 69 mm, and 1.3% were ≥ 10 mm. Prevalence rate of selected comorbidities were as follows: liver disease, 1.8%; diabetes mellitus, 25.5%; hypertension, 25.5%; and dyslipidemia, 29.8%. The prevalence in male and female patients was 7.7% and 7%, respectively. The prevalence of GB polyps was higher in south-eastern patients (21.4% of positive cases) and was the highest in the overweight group (8.8%). A higher prevalence was noted in the hypertensive group (hypertensive group, 9.8%; non-hypertensive group, 6.6%) and dyslipidemia group (dyslipidemia group, 7.8%; no dyslipidemia group, 7.2%). Moreover, a higher prevalence was noted in hepatitis B surface (HBS)-positive group (15%) than in the HBS-negative group (8.2%) and slightly higher in Helicobacter pylori antigen positive group than in the negative group. Conclusion: Abdominal US is an important and commonly used imaging modality in the detection of GB polyps. In this study, the prevalence of GB polyps was approximately 7.4%, with higher prevalence in participants who were overweight and had diabetes mellitus, hypertension, and dyslipidemia.

The Six Minute Walk Test as a Marker of Functional Capacity in Hypertensive Patients

Background: Currently, hypertension becomes one of the leading issues not only for medical community but also to the broader societies. Even though hypertension could be symptomatic, in most case it didn’t until the devastating complications shows up. Functional capacity is a simple tool based on our daily activity. The six-minute walk test could be one of the simplest ways in measuring functional capacity. Six-minute distance as the outcome of this test could be potentially a marker for functional capacity in hypertensive group compare to non-hypertensive group.Methods: This is a case control study with 34 female participants in six-minute walking test.Result: There are no significant different of age, height, weight, and body max index between those groups. The six-minute walking distance drastically difference between hypertensive and non-hypertensive group, 306m and 367m respectively with p-value < 0,01. Heart rate pre-test also statistically different between control group and case group. (75 bpm and 94 bpm, p-value = 0,027) Post-test blood pressure is notably distinctive between two groups. Additionally, systolic blood pressure post-test lower than initial value. Hypertension alters human functional capacity ominously.Conclusion : The six-minute walk test could be applied as simple functional capacity marker in hypertension subject.

Pre-Hypertension and Its Determinants in Healthy Young Adults: Analysis of Data from the Korean National Health and Nutrition Examination Survey VII

The purpose of this cross-sectional study was to identify risk factors in the normotensive and pre-hypertensive group based on the blood pressure results of healthy young adults from the Korean National Health and Nutrition Examination Survey 2018. The participants were 2225 healthy young adults between the ages of 19 and under 45, excluding those with a diagnosis of hypertension or taking antihypertensive medications. Of the 2225 participants, the normotensive group was 1498 (67.3%) and the pre-hypertensive group 727 (32.7%). Determinants of pre-hypertension were analyzed using multiple logistic regression based on a complex sample design. Factors related to pre-hypertension in young adults were age, smoking, waist circumference, diabetes, anemia, cholesterol levels including HDL cholesterol, and uric acid levels. Pre-hypertension is a pre-stage that can prevent the morbidity of hypertension through lifestyle control, so its management is very important. Furthermore, a young adult is a stage in the growth and development of human beings, in which lifestyles such as healthy behaviors, eating habits, and exercise are fixed. Therefore, it is very important to improve lifestyles such as diet, exercise, and smoking cessation and to control risk factors in young adults who are at the pre-hypertension stage for health promotion. Continuous health examinations should be conducted for young adults, and education that can be practiced based on clinical data through this should be implemented for community health.

Arterial Hypertension and Diabetes Mellitus in COVID-19 Patients: What Is Known by Gender Differences?

Background. Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected >160 million people around the world. Hypertension (HT), chronic heart disease (CHD), and diabetes mellitus (DM) increase susceptibility to SARS-CoV-2 infection. Aims. We designed this retrospective study to assess the gender differences in hypertensive diabetic SARS-CoV-2 patients. We reported data, by gender differences, on the inflammatory status, on the hospital stays, intensive care unit (ICU) admission, Rx and CT report, and therapy. Methods. We enrolled 1014 patients with confirmed COVID-19 admitted into different Hospitals of Campania from 26 March to 30 June, 2020. All patients were allocated into two groups: diabetic-hypertensive group (DM-HT group) that includes 556 patients affected by diabetes mellitus and arterial hypertension and the non-diabetic- non-hypertensive group (non-DM, non-HT group) comprising 458 patients. The clinical outcomes (i.e., discharges, mortality, length of stay, therapy, and admission to intensive care) were monitored up to June 30, 2020. Results. We described, in the DM-HT group, higher proportion of cardiopathy ischemic (CHD) (47.5% vs. 14.8%, respectively; p < 0.0001) and lung diseases in females compared to male subjects (34.8% vs. 18.5%, respectively; p < 0.0001). In male subjects, we observed higher proportion of kidney diseases (CKD) (11% vs. 0.01%, respectively; p < 0.0001), a higher hospital stay compared to female subjects (22 days vs. 17 days, respectively, p < 0.0001), a higher admission in ICU (66.9% vs. 12.8%, respectively, p < 0.0001), and higher death rate (17.3% vs. 10.7%, respectively, p < 0.0001). Conclusion. These data confirm that male subjects, compared to female subjects, have a higher hospital stay, a higher admission to ICU, and higher death rate.

Reference data among general population and known-groups validity among hypertensive population of the EQ-5D-5L in Vietnam

Purpose This study aims to provide EQ-5D-5L population norms among the general population in Vietnam and to test EQ-5D-5L’ construction validity among people living with hypertension there. Methods Descriptive statistics of the five dimensions and five levels, EQ-VAS and EQ-5D-5L indexes were categorised into gender and age groups for the EQ-5D-5L population norms. Known-groups testing was set for lower EQ-5D-5L outcomes among people who were aware of their hypertensive status, females, people with more comorbidities, less education, older ages, and higher body mass indexes. Level of confident interval was 95%. Results The mean EQ-VAS and EQ-5D-5L indexes were 81.10 (SD: 13.35) and 0.94 (SD: 0.09) among the general population. The EQ-5D-5L outcomes were better among younger people, males, people with more education, employees, and single people. Respondents reported fewer problems with self-care and usual activities and tend to have problems at higher levels across older ages. The known-group testing showed statistically significant results. The mean EQ-VAS and EQ-5D-5L indexes of people in the diagnosed hypertensive group (71.48 and 0.94, respectively) were statistically significantly smaller than they were in the non-hypertensive and undiagnosed hypertensive group (76.65 and 0.97; 76.95 and 0.96 accordingly). Statistically significant associations of lower EQ-5D-5L indexes and EQ-VAS were found among people diagnosed for hypertension, people suffering from an incremental comorbidity, and obese people. Conclusion This study has provided EQ-5D-5L population norms for the general population and evidence for known-groups validity of the EQ-5D-5L instrument among hypertensive people in Vietnam.

High Levels of Tumor Necrosis Factor-Alpha Reduce Placental Aquaporin 3 Expression and Impair in vitro Trophoblastic Cell Migration

Placentas from preeclamptic women display augmented tumor necrosis factor-alpha (TNF-α) levels with reduced expression of aquaporin 3 (AQP3). However, whether TNF-α modulates AQP3 expression remains to be elucidated. We hypothesize that elevated levels of TNF-α reduce AQP3 expression and negatively impact trophoblastic cell migration. Spontaneously hypertensive rats (SHRs) and Wistar rats (14–16 weeks) were divided into hypertensive and normotensive groups, respectively. Systolic blood pressure (SBP) was measured, and animals mated. In a third group, pregnant SHRs were treated with a TNF-α antagonist, etanercept (0.8 mg/kg, subcutaneously) on days 0, 6, 12, and 18 of pregnancy. Placentas were collected on the 20th day of pregnancy. Human placental explants, from normotensive pregnancies, were incubated with TNF-α (5, 10, and 20 ng/ml) and/or etanercept (1 μg/ml). Swan 71 cells were incubated with TNF-α (10 ng/ml) and/or etanercept (1 μg/ml) and subjected to the wound healing assay. AQP3 expression was assessed by Western blot and TNF-α levels by ELISA. SBP (mmHg) was elevated in the hypertensive group, and etanercept treatment reduced this parameter. Placental TNF-α levels (pg/ml) were higher in the hypertensive group. AQP3 expression was reduced in the hypertensive group, and etanercept treatment reversed this parameter. Explants submitted to TNF-α exposition displayed reduced expression of AQP3, and etanercept incubation reversed it. Trophoblastic cells incubated with TNF-α showed decreased cell migration and reduced AQP3 expression, and etanercept incubation ameliorated it. Altogether, these data demonstrate that high TNF-α levels negatively modulate AQP3 in placental tissue, impairing cell migration, and its relationship in a pregnancy affected by hypertension.

Comparison of Intraocular Pressure among Individuals with Systemic Hypertension and those with Normal Blood Pressure

Introduction: Systemic blood pressure, by far, is one of the most important factors that can have an effect on intraocular pressure. We have compared the intraocular pressure (IOP) among patients with systemic hypertension and those with normal blood pressure. Materials and methods: A hospital based case control study was conducted from March 2017 to March 2018 in the Ophthalmology outpatient department at Dhulikhel Hospital. A total of 100 patients with hypertension were included in the case group (hypertensive group) and 100 cases with no systemic or ocular disease were included in the control group (normotensive group). Mean intraocular pressures were calculated and compared between the two groups. Results: Mean age of patients was 49.03 years in hypertensive group and 47.53 years in normotensive group. Mean IOP of the right eye in those with hypertension was 16.10 mmHg and in the left eye was 15.8 mmHg. Similarly mean IOP of the right eye in the normotensive group was 15.8 mmHg and the left eye was 16.2 mmHg. The difference between mean IOP of hypertensive and normotensive individuals was not statistically significant (p > 0.05). The prevalence of ocular hypertension was found to be 7.5%. Conclusion: There was no statistically significant difference in IOP between hypertensive and normotensive individuals. However, a statistically significant difference in IOP was noted between ‘hypertensive with controlled blood pressure’ and ‘hypertensive with uncontrolled BP’ indicating that high blood pressure may be associated with high IOP.

Genetic Variation in Taste Receptor Genes (SCNN1B, TRPV1) and Its Correlation with the Perception of Saltiness in Normotensive and Hypertensive Adults

Background. Different taste preferences correlated with genetic variations may lead to food consumption patterns that contribute to nutrient-related health outcomes such as hypertension. Objectives. The aim of this study was to determine whether single nucleotide polymorphisms (SNPs) in the salt taste receptor genes SCNN1B and TRPV1 affect salt taste perception among normotensive and hypertensive people. Materials and Methods. We conducted a cross-sectional case control study by design consisting of a normotensive and hypertensive group. Participants were 253 adults with age range of 20–82 residing in Mississippi, USA. For each of 128 normotensives and 125 hypertensives, the salt taste recognition threshold and salt taste receptor genotype were determined. Results. The hypertensive group had a higher salt taste recognition threshold than the normotensive group ( P < 0.001 ). The polymorphism of TRPV1, rs4790522, with the AA genotype was associated with a higher salt recognition threshold (lower salt taste sensitivity) in people with hypertension and obesity. Moreover, the polymorphism of TRPV1, rs8065080, and SCNN1B, rs239345, genes were associated with a risk of hypertension ( P = 0.016 and P = 0.024 ). Conclusion. Correlations between SNPs, salt taste sensitivity, and hypertension risk were observed. People with hypertension had a higher salt taste threshold than those with normotension.

Assessing the Medication Adherence of Metabolic Disorders in South India

Aim: The study's main objective was to assess patients' adherence towards treatment and daily practices among Hypertension (HT), Diabetes Mellitus (DM) Type II and hypothyroid participants in South India before and after providing counseling and education based on WHO standards. Study Design: The present study is a prospective open-labeled observational study. Place and Duration of the Study: The present study was conducted in Vijayawada, South India for six months. Methodology: A total of 490 participants with Hypertension, Diabetes Mellitus (Type II) and Hypothyroidism were assessed for adherence based on the Morisky medication adherence scale containing 8 points at the starting of the study and 6 months after providing counseling and education. Results: At the initial point of study, only 12% of the Hypertensive group, 17% of Diabetes Mellitus (Type II) and 15% Hypothyroid group have high adherence. Towards the completion of the study, around 41% in the Hypertensive group, 50% of Diabetes Mellitus (Type II) and 60% Hypothyroid group had high adherence. Conclusion: The adherence was low at the initial point of the study among all the three groups. After counseling and education provided through the World Health Organization (WHO) specified criteria, we have seen a good increase in the adherence, measured with the MMAS-8 scale. Greater efforts should be made in educating and counseling the patients suffering from such chronic illnesses to improve their quality of life.

Gene expression in implant surgery patients: a description of bone and inflammation markers

This research describes the gene expression of molecules related to inflammation and bone metabolism in all patients submitted to dental implant surgery attended at a Brazilian institution. A convenience sample was collected over 2 years. The bone samples were processed for extraction of total RNA and reverse transcription of cDNA. Relative quantification by real-time polymerase chain reaction of target genes was performed. The sample was characterized demographically and according heath conditions. The patients were grouped. The control group was composed of 17 healthy patients, 6 patients were included in the antihypertensive therapy group, 3 were smokers, another 3 were smokers and were under antihypertensive treatment, and 3 were ex-smokers (smoked for 10 years but had quit for at least 5 years). The ex-smoker group presented the highest values, and the Hypertensive group presented the lowest values of Macrophage colony-stimulating factor, Osteonectin, Bone Morphogenetic Protein II, and Integrin. All smokers demonstrated expression values comparable to the Control group. The highest expression values of Osteopontin, RUNX, and Alkaline Phosphatase were observed in the Hypertensive and the Smoker group, while the lowest values were found in the Hypertensive group. Smokers, Ex-smokers, and the Control group demonstrated similar values. As conclusion, gene downregulation was observed in patients under anti-hypertensive therapy. Smoke seems to reduce expression of genes involve in bone formation and increase genes responsible for resorptive activity. This pattern of genic expression may be involved in higher implant loss, observed in smokers. Stop smoke seems to return expression of some of these genes.