Main Risk Factors For Diseases Research Articles

Protocolo terapéutico de la hipertensión esencial

Hypertension (HT) is the main risk factor for disease and death in the world, and properly controlling it reduces the risk of associated morbimortality. Essential HT is the most common form of HT (90%-95%), and genetic as well as environmental factors are implicated in its development. When considering a therapeutic protocol in a hypertensive patient it is important to quantify the vascular risk and define a control target. Following the 2018 recommendations of the European Society of Hypertension and the European Society of Cardiology, in the majority of cases it is indicated to simultaneously commence with lifestyle modifications and pharmacological treatment. The recommendation is to always start treatment with a combined therapy, except in patients with BP close to the target and in patients who are frail or over the age of 80 years. For the majority of patients a combination of an angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor antagonist II (ARA II) with a calcium antagonist or a thiazide will be preferable, although we should always individualize the treatment and control targets according to the patient's profile, while also considering special situations such as heart failure, auricular fibrillation, heart disease, chronic kidney disease or resistant HT.

HEMORHEOLOGICAL FEATURES IN PATIENTS WITH CEREBROVASCULAR DISEASE ON THE BACKGROUND OF DIABETES MELLITUS

Diabetes meUitus, as one of the main risk factors for diseases of the circulatory system, significantly increases the likelihood of the formation of cerebrovascular pathology, therefore, improving the diagnosis of hemorheological disorders is a priority area of medicine. According to the results of a study of 68 patients with acute cerebrovascular accidents against the background of type 2 diabetes mellitus, it was found that with an increase in the length of the disease, chronic hyperglycemia and an increase in the level of HbA1c, the complex of hemorheological disorders increases. The development of a vicious circle in the pathogenesis of endocrinopathy creates the prerequisites for the further progression of micro- and macrovascular complications.

Does malnutrition in clubfoot patients affect Ponseti technique and its outcome?

Malnutrition is a crucial health problem predominantly in the developing countries. Malnutrition in children is one of the main risk factors for diseases and mortality. Club foot or congenital talipes equinovarus (CTEV) is the most common form of congenital orthopaedic abnormality. Over the past 20years, the Ponseti method is considered the gold standard for the treatment of clubfoot. Our objective is to determine the prevalence of malnutrition in clubfoot patients, and its effects on the outcome of Ponseti technique in patients presenting to the Orthopaedic Clinic of tertiary care Hospital in Karachi, Pakistan. The cross-sectional study was conducted from January to December 2018. Total 153 clubfoot patients were treated and the World Health Organization (WHO) classification of weight-for-age index was used to assess the nutritional status of patients, and its impact on outcome of Ponseti technique was recorded and analysed with a P value≤.05 as significant. Of the 153 patients, 112 (79.7%) were found in good nutritional status and 42 (20.6%) were malnourished. The average number of casts per patient and patients requiring 6+casts in the undernutrition group was higher compared with good nutrition group (45.5% vs 21.42%, respectively). The number of Achilles tenotomy performed in the undernutrition group was also higher (76.4% vs 51.8%). A significant correlation between patients' nutritional status and outcome of the Ponseti technique is found as it influences the number of casts, possible relapse and failure of treatment.

The efficacy of ethylmethylhydroxypyridine succinate in patients with cerebrovascular pathology complicated with diabetes mellitus and metabolic syndrome

Arterial hypertension, diabetes mellitus, obesity and dyslipidemia continue to be the main risk factors for diseases of the circulatory system and the leading causes of mortality in the world, the combination of these diseases significantly increases the likelihood of the development and more rapid progression of cardiovascular and cerebrovascular pathology. Improving approaches to the diagnosis and treatment of these diseases is a priority problem in modern medicine. Currently, there is no universal drug that can influence all stages of pathological process in both cerebrovascular diseases and diabetes mellitus, and the problem of rational use of drugs in patients with comorbid pathology has not been completely resolved. A difficult clinical task includes not only the timely detection of the disease and the correct diagnosis, but also the choice of the safest and most effective medicine. A number of clinical studies have demonstrated the efficacy of mexidol in the treatment of this category of patients, which is determined by its complex, pleiotropic and multimodal mechanisms of action.

Nicotine Response to Interval Training in Male Smokers

AbstractBackground: Tobacco overtaking, sedentary lifestyle and low fitness considered as the main risk factors for diseases that leads to death, such as, coronary heart disease, stroke, obesity and hypertension which are the most common causes of morbidity and mortality.Aim of Study: The purpose of this study was to find out the effect of interval training on nicotine in male smokers.Subject and Methods: The study was conducted on thirty smokers in New Cairo Hospital started at August 2017 and had been finished at December 2018, their age ranged from 20 to 40 years their BMI ranged from 25 to 29.9kg/m2 all subjects were thoroughly evaluated before and after the exercise protocol application. Initial assessment were included measurements of body weight, body height, and nicotine blood levels, all were free from musculoskeletal disorders or cardiovascular disorders, then subjects started treatment program as following, performing a supervised running on treadmill in pattern of high intensity interval training for 30 minutes, 3 sessions per week for 8 weeks. Each training session was consisted of 5 minutes of warming-up walking, 10 minutes of high intensity interval training consist of 2 repeats of (1min running at 85-95% of MHR then followed by 4min recovery at 60-70% of MHR), and ended with 5 minutes of cool-down walking.Results: Statistical analysis showed a significant improve-ment (decrease) in cotinine level (nicotine) by 39.94%.Conclusion: It is recommended for smokers to participate in high intensity interval training to decrease smoking craving, and then smoking cessation.

Kicking off the Special Interest Group Population Health Management– how can the scaling up of innovative success stories be supported?

Why a special interest group on Population Health Management? Context, aims and objectives. In the past the responsibilities for health care services provision and public health have largely been seen as separate functions of the health system. This was rooted in the evolution trajec-tories of both functions, one dealing with an increasingly effective array of services for the curative treatment of individuals and the other addressing collective responsibilities targeting _classic_ public health functions (e.g. immunization and environmental health risk reduction) and _new_ public health functions (e.g. a focus on health-related behaviour and the social de-terminants of health). Both functions have contributed to increasing life expectancy and im-proving health-related quality of life. Addressing the current and future health system chal-lenges characterized by the burden of chronic diseases and an ageing population; however, requires a better alignment of care provision and public health: the main risk factors of dis-ease and disability in developed countries (such as hypertension, tobacco, alcohol misuse, high body mass index, low physical activity) are amenable to a range of health care and pub-lic health interventions that require a coordinated effort across the health system. Thus, a common element of recent health system innovations is the link between integrated care provision and public health functions, culminating in strategies to improve population health. Population health, defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group” (Kindig D & Stoddard G, American Journal of Public Health 2003), implies a co-responsibility of the health care and public health system to reach the shared aim of health improvement. Examples of such innovations include Kaiser Permanente in the USA, the integrated care pioneers and vanguards in the UK, the Alzira care model in Spain, the experience of Gesundes Kinzigtal in Germany, or the population health approach in Jonkoping Council in Sweden. Common to these models is the shared responsibility for integrated care provision and population health, the use of innovative approaches to management, and improvement strategies supported by health data analytics. The key question is now: can the excellent results of these innovators be translated to other systems and be scaled up to address larger populations? Moreover, which factors need to be considered in this process (such as population health structures and demographic profiles, baseline performance of the existing health service de-livery network, legal, technological and methodological prerequisites for advanced data analytics, etc.)? In order to address these questions, a Special Interest Group (SIG) Population Health Man-agement will be initiated under the auspices of the International Foundation for Integrated Care (IFIC). The _aim_ of the Special Interest Group is *to support the identification and scal-ing up of innovative approaches to improvement population health*. In order to reach this aim, the SIG will pursue the following objectives: - Identify, synthesize and share information on innovative examples that link integrated care provision and public health functions - Appraise their evidence base, develop and recommend robust methods for the evalu-ation of these complex interventions - Identify context factors crucial for their transferability and scalability - Assess, develop and publish tools that can be widely applied for population health im-provement A first step to inaugurate the SIG will be an overview on innovative case studies, which will be discussed at the workshop. Workshop participants will then have the opportunity to split into working groups to identify the questions that underlie the transferability, scalability and practi-cal implementation of the case studies. The SIG will provide a forum to discuss the current state-of-the-art in population health man-agement, connect interested researchers, managers and policy makers to pursue research and implementation projects and develop discussion and position papers on the topic. The SIG will also aim to set up a special section in which junior researchers can identify and dis-cuss topics for PhD projects and discuss these with senior members of the SIG. Target participants : The target audience consists of researchers, managers and decision-makers engaged in or in interested in improving population health. Other participants of the ICIC2016 with a relevant background and junior researchers are welcome.

Identification of Suitable Areas for African Horse Sickness Virus Infections in Spanish Equine Populations.

African horse sickness (AHS) is one of the most important vector-borne viral infectious diseases of equines, transmitted mainly by Culicoides spp. The re-emergence of Culicoides-borne diseases in Europe, such as the recent bluetongue (BT) or Schmallenberg outbreaks, has raised concern about the potential re-introduction and further spread of AHS virus (AHSV) in Europe. Spain has one of the largest European equine populations. In addition, its geographical, environmental and entomological conditions favour AHSV infections, as shown by the historical outbreaks in the 1990s. The establishment of risk-based surveillance strategies would allow the early detection and rapid control of any potential AHSV outbreak. This study aimed to identify the areas and time periods that are suitable or at high risk for AHS occurrence in Spain using a GIS-based multicriteria decision framework. Specifically risk maps for AHS occurrence were produced using a weighted linear combination of the main risk factors of disease, namely extrinsic incubation period, equine density and distribution of competent Culicoides populations. Model results revealed that the south-western and north-central areas of Spain and the Balearic Islands are the areas at the highest risk for AHSV infections, particularly in late summer months. Conversely, Galicia, Castile and Leon and La Rioja can be considered as low-risk regions. This result was validated with historical AHS and BT outbreaks in Spain, and with the Culicoides vector distribution area. The model results, together with current Spanish equine production features, should provide the foundations to design risk-based and more cost-effective surveillance strategies for the early detection and rapid control potential of AHS outbreaks in Spain.

Focus on blood pressure as a major risk factor

The main risk factor for disease and premature death worldwide is high blood pressure.1 The associations between blood pressure and fatal coronary artery disease and fatal stroke have been well demonstrated.2 However, little evidence exists from contemporary clinical practice on the associations between blood pressure and morbidity and mortality from specific cardiovascular disease conditions in different age groups. Also missing are results concerning lifetime risk for specific cardiovascular complications associated with hypertension.

Risk factors for sporadicYersinia enterocoliticainfections, Germany 2009–2010

Yersinia enterocolitica is an important cause of acute gastrointestinal disease and post-infectious complications. In Germany, incidence of reported yersiniosis is relatively high compared with other countries of the European Union. Children aged <5 years are most frequently affected. The aim of our study was to identify risk factors for sporadic yersiniosis in Germany. A population-based case-control study was conducted in five federal states of Germany from April 2009 to June 2010. Cases exhibiting gastrointestinal symptoms were notified to the local health department with a Yersinia enterocolitica infection culture-confirmed from stool. Controls were selected from population registries and frequency-matched on age group and state of residency. Cases and controls received a questionnaire on possible risk factors by mail. Multivariable logistic regression modelling was used to identify risk factors and to calculate adjusted odds ratios (aORs). Population attributable fractions (PAFs) were estimated for exposures associated with yersiniosis. We analysed data on 571 case patients and 1798 controls. Consumption of raw minced pork, a dish frequently consumed even by young children in Germany, was the main risk factor for disease (aOR 4·7, 95% confidence interval (CI) 3·5-6·3, PAF 30%). This association varied by age group and, unexpectedly, was strongest for children aged <2 years (aOR 17·5, 95% CI 6·0-51·2). Other independent risk factors included recent preparation of minced pork in the household (aOR 1·4, 95% CI 1·1-1·9, PAF 21%), playing in a sandbox (aOR 1·7, 95% CI 1·3-2·4, PAF 17%), and contact with birds (aOR 1·7, 95% CI 1·1-2·6, PAF 4%). Prevention efforts should specifically target parents and caregivers of young children and focus on the high infection risk associated with consumption of raw minced pork.

Heart rate and mortality from cardiovascular causes: a 12 year follow-up study of 379 843 men and women aged 40-45 years

To study the relationship between heart rate and (a) all deaths and (b) cardiovascular deaths in a large cohort of middle-aged Norwegian men and women. A prospective study of participants in cardiovascular surveys that were carried out in 1985-1999 and covered men and women aged 40-45 years in all counties except the capital, Oslo. In total, 180,353 men and 199,490 women aged 40-45 years without cardiovascular history or diabetes accrued 4 775 683 years of follow-up. There was a positive and graded association between heart rate and mortality from all causes, as well as between heart rate and deaths from cardiovascular disease (CVD), ischaemic heart disease, and stroke. However, these associations were greatly reduced when we adjusted for the main risk factors of disease. The hazard ratios for any death were reduced from 3.14 to 1.82 for men (95% CI, 1.62-2.04) and from 2.14 to 1.37 for women (95% CI, 1.19-1.59), when we compared > or =95 b.p.m. with <65 b.p.m. The corresponding figures for CVD were a reduction from 4.79 to 1.51 for men (95% CI, 1.21-1.87) and from 2.68 to 0.78 for women (95% CI, 0.53-1.15). In this cohort of middle-aged men and women, a crude association between heart rate and death from CVDs was greatly weakened when we adjusted for the main risk factors of disease. This suggests that an increased heart rate in middle age may be a marker of high cardiovascular risk, but is not an independent risk factor.