Cardiovascular Disease Behavioural Risk Factors in Rural Interventions: Cross-Sectional Study.

Aims:This study aims to 1) assess the prevalence of cardiovascular disease (CVD) behavioural risk factors in patients who have undergone percutaneous coronary intervention (PCI) 2) identify target risk factor(s) for behaviour modification intervention, and 3) develop an analytical model to define cluster(s) of risk factors which could help make any generic intervention more targeted to the local patient population.Subject and Methods:Study patients with at least one CVD behavioural risk factors living in a rural region. The study used STROBE methodology for cross-sectional studies. Demographic and clinical data of patients (n=2025) were collected at the point of admission for PCI between 04.01.2016 to 31.12.2019. Collected data distributions were analysed by CVD behavioural risk factors for prevalence, associations, and direction of associations. Cluster definition was measured by assignment of a unit score each for overall level of prevalence and significance of associations, and general logistics modelling for direction and significance of risk.Results:The mean (SD) age was 69.47(±10.93) years [95% CI (68.99 - 69.94)]. The key risk factors were hyperlipidaemia, hypertension, and elevated body mass index (BMI). Approximately 40% of the population have multiple risk factor counts of two. Analytical measures revealed a population risk factor cluster with elevated BMI [77.5% (1570/2025)] that is mostly either hyperlipidaemic [9.43%, co-eff. (17), P=.007] or hypertensive [22.72%, co-eff. (17), P=.99] as key risk factor clusters.Conclusion:Carefully modelled analyses revealed clustered behavioural risk associated with elevated BMI. This information would support a strategy for applying targeted clusters in novel interventions to improve implementation efficiency.Conclusion: Risk factors, cardiovascular disease, obesity, and percutaneous coronary intervention.

Comparison of COVID-19 vaccine prioritization strategies

Background: For countries that have only recently started COVID-19 vaccinations, there remains a key public health question of who should be prioritized for early vaccination. Most vaccine prioritization analyses have only considered variation in risk of infection and death by age. We provide a more granular analysis with stratification by demographics, risk factors, and location. Methods: We used a simulation model to compare the impact of different prioritization strategies on COVID-19 cases, deaths and disability-adjusted life years (DALYs) over the first 6 months of vaccine rollout. We calibrated the model to demographic and location data on 28,175 COVID-19 deaths in California up to December 30, 2020, and incorporated variation in risk by occupation and comorbidity status using published estimates. We estimated the proportion of clinical cases, deaths and DALYs averted relative to a scenario of no vaccination for strategies prioritizing vaccination by a single risk factor (special population status (e.g. incarcerated individual), age, essential worker status, comorbidity status) or multiple risk factors (e.g. age and location). Results: We found that age-based targeting averted the most deaths (65% for 5 million individuals vaccinated) and DALYs (40%) of strategies targeting by a single risk factor and targeting essential workers averted the least deaths (33%) and DALYs (25%) over the first 6 months of vaccine rollout. However, targeting by two or more risk factors simultaneously averted up to 40% more DALYs. Conclusions: Our findings highlight the potential value of multiple-risk-factor targeting of COVID-19 vaccination. Where vaccine supply is limited and logistical challenges in vaccine delivery persist, age-based targeting offers a means of ensuring that vaccines reach those most at risk of poor health outcomes. If operational challenges can be overcome, more granular vaccination strategies that overlap age with other risk factors can be adopted.

Mild COVID-19 manifestation in multiple risk factor patient on methotrexate, who had been treated with UVB phototherapy and had sufficient plasma 25-OH-vitamin D3 level

We report mild COVID-19 manifestation in high-risk patient with sufficient plasma 25-OH-Vitamin D3 level. Given the global pandemic of vitamin D deficiency, as well as its likely beneficial effects during SARS-CoV-2 infection, report highlights importance of routine 25-OH-Vitamin D3 measurement, either for clinical course prediction or deciding on supplementation.

The Relationship between the IFNG (rs2430561) Polymorphism and Metabolic Syndrome in Perimenopausal Women

Background and Objectives: Metabolic syndrome (MetS) is a multiple risk factor for atherosclerosis, cardiovascular disease, type 2 diabetes and strokes. One-third of middle-age women are at risk of MetS, which predisposes them to type 2 diabetes and cardiovascular disease. Changes in the regulation of anti-inflammatory cytokines―which play an important role in pathologic processes―may contribute to inflammatory disorders. Cytokine polymorphisms are known to have an impact on gene expression. The purpose of this study was to search for the relationship between the IFNG polymorphisms and the levels of proinflammatory cytokines. Materials and Methods: This study, conducted in West Pomeranian Voivodeship, Poland, involved 416 women. Of these women, 33.6% of them had primary education, 44.8% lived in cities with a population of over 100,000, and 82.7% were married. Of the participants, 28.4% met the criteria for MetS. The study involved: interview performed to collect sociodemographic and medical data, anthropometric measurements, as well as venous blood collection for biochemical analysis, genetic testing and the measurement of inflammatory markers. Results: The link between the IFNG (rs2430561) polymorphism and serum PIC (proinflammatory cytokines) levels was tested with regard to MetS. In the MetS+ subgroup, the T/T and A/T genotypes of the IFNG gene were accompanied by higher IL-6 levels than in the MetS− subgroup. Conclusion: Our study has not confirmed a direct link between the IFNG polymorphisms and the levels of inflammatory biomarkers. Nevertheless, the T/T and A/T genotypes of the IFNG gene may predispose to elevated IL-6 levels.