Periodic Health Examination Research Articles

Measured obesity and overweight in adults: the Italian Health Examination Survey 2023-CUORE Project

Abstract Background The WHO recommends to halt the rise of obesity by 2025, considering 2010 as baseline. This analysis aims to assess if Italy can meet the WHO target in the general adult population using data measured in the periodic health examination surveys (HESs) conducted within the CUORE Project. Methods In the HES started in 2023, mean level of BMI and prevalence of obesity (BMI > =30 kg/m2) and overweight (25 < =BMI< 30 kg/m2) were assessed in representative random samples of resident population, aged 35-74 years, stratified by age and sex (727 men and 706 women), from 7 (of 20) Italian Regions, in Northern, Central and Southern Italy. Weight and height were measured using standardized methods. Insufficient physical activity was defined as less than 150 minutes of moderate-intensity activity per week, or equivalent. The survey is funded by the Italian Ministry of Health-CCM. Results Prevalence of obesity was 23% (95% C.I. 16-29%) in men and 25% (19-31%) in women; prevalence of overweight was 47% (39-54%) in men and 30% (24-37%) in women. Mean level of BMI was 27.5 kg/m2 (27.2-27.8 kg/m2) in men and 26.9 kg/m2 (26.4-27.3 kg/m2) in women. Obesity resulted tendencially higher in persons with insufficient physical activity (27%, with 95% C.I. 17-36% in men; 28%, 19-37% in women) than among those without (19%, 11-27% in men; 21%, 12-30% in women), and in persons with primary or secondary school education (29%, 17-40% in men; 32%, 20-44% in women) than in those with higher educational level (20%, 12-27% in men; 21%, 14-28% in women). Conclusions Going in the direction of WHO target, preliminary data collected within 2023 showed a prevalence of obesity not statistically different in comparison to HES data of 15 and 5 years ago, both in men and women, however, 70% of men and 55% of women are in the overweight/obesity condition. Preventive actions at national and community level should be still massively implemented. Key messages • Prevalence of obesity and overweight resulted still at epidemic level in the Italian adult general population. • In the Italian adult population stable obesity prevalence trend was observed in comparison to 15 and 5 years ago.

Blood pressure and its control in adults: the Italian Health Examination Survey 2023-CUORE Project

Abstract Background The WHO recommends a 25% relative reduction in the prevalence of raised blood pressure (RBP) by 2025, considering 2010 as baseline. To monitor the achievement of this target, prevalence of RBP and mean blood pressure were measured in the Italian general adult population within periodic health examination surveys (HESs) conducted within the CUORE Project. Methods In 2023 a new HES started including, up to now, data from random samples of residents aged 35-74 years (706 men, 727 women) in 7 Regions (of 20 regions) distributed in North, Centre and South of Italy. Blood pressure was measured at the right arm, in sitting position, by automated oscillometric device using standardized procedures and methods; the average of two measurements performed with 1 minute interval was used for the analysis. RBP is defined as systolic and/or diastolic blood pressure equal or greater than 140/90 mmHg. The survey is funded by the Italian Ministry of Health-CCM. Results Preliminary analysis shows that prevalence of RBP is 37% (95% Confidence Interval-CI: 30-46%) in men and 23% (17-29%) in women. Mean value of systolic blood pressure is 134 mmHg (133-136 mmHg) in men and 126 mmHg (125-127 mmHg) in women. Mean value of diastolic blood pressure is 80 mmHg (78-81 mmHg) in men and 75 mmHg (74-76 mmHg) in women. Among those with RBP and/or in treatment (49% of men and 39% of women), 35% of men and 19% women are unaware they could have BP control problems, 8% and 9% are aware but not in treatment, 24% and 40% are under treatment and at target, 33% and 22% are under treatment but not at target, respectively. Conclusions These preliminary data underline that RBP is still high in the Italian adult population. Significant reductions in RBP prevalence occurred in comparison to previous HES data, 20% from 25 years ago, about 10% from 15 year ago, while a stable trend was found in comparison to 5 years ago. Improvements on RBP awareness and control are still necessary. Key messages • Raised blood pressure is still high in the Italian general adult population. • Implementing periodic HES is fundamental to measure blood pressure and estimate awareness and control of hypertension in the general population.

Lipids and glycemia profiles in adults: the Italian Health Examination Survey 2023 - CUORE Project

Abstract Background WHO recommends monitoring glycemic and lipid profiles in the population to control and prevent NCDs. The target for glycemic/diabetes is to halt the rise within 2025 (2010 as baseline). The Italian Ministry of Health (MoH) has strengthened prevention/health promotion and supported their periodic assessment through national health examination surveys (HESs), financed by MoH-CCM and conducted within the CUORE Project. Methods In 2023 a new HES started including the assessment of fasting serum glycemia, total and HDL cholesterolemia and triglyceridemia. Up to now, data from random samples of residents in 7 Regions (of 20 regions) distributed in North, Centre and South of Italy and aged 35-74 years are available (687 men, 704 women). Glycemia and lipids profiles were assayed by a central lab. Elevated glycemia/diabetes (DM): glycemia ≥ 126 mg/dl and/or on medication. Elevated total cholesterol/hypercholesterolemia (HChol): total cholesterol ≥ 240 mg/dl and/or on medication. Results Glycemia mean level was 97 mg/dl (95%CI: 95-99) in men and 90 mg/dl (89-91) in women; DM resulted 10% (5-14) and 8% (4-12) respectively. Among those with DM, about 2 in 10 men and 1 in 10 women were unaware; about 2 and 3 of 10 were aware but not on medication, respectively. Total cholesterol mean level was 192 mg/dl (189-195) in men and 200 (197-202) in women; HChol resulted 24% (18-31) and 29% (22-36) respectively. Mean level of HDL cholesterol was 48 mg/dl (48-49) in men and 59 mg/dl (58-60) in women; mean level of triglycerides was 121 mg/dl (115-126) and 95 mg/dl (92-98) respectively. Among those with HChol, about 1 in 10 men and 2 in 10 women were unaware; about 2 of 10 were aware but not on medication. Conclusions Compared to 2008, these preliminary data showed a significant decrease of glycemia, total cholesterol and triglycerides means values both in men and women, as well as of DM and HChol prevalence, but improvements on their awareness and control are still necessary. Key messages • In the Italian adult general population significant improvements in lipids and glycemia profiles occurred compared to 15 years ago. • The implementation of periodic health examination surveys is important for estimating indicators based on objective measurements and for estimating awareness and control of risk conditions.

Health locus of control, perceived health competence, and satisfaction of patients with rheumatological conditions versus periodic health examination patients

ABSTRACT Important health management goals include building patient loyalty, predicting patient behavior and adherence, and understanding treatment outcomes. This study focused on health locus of control (HLC), perceived health competence, and satisfaction with care in an outpatient sample by comparing chronic care patients and periodic health examination (PHE) patients in the same clinic. The study sample consisted of 146 adult patients from a rheumatology outpatient clinic. Participants responded to validated measures of psychosocial variables and answered a sociodemographic and health status information form. The findings showed that while both patient groups were similarly satisfied with care, chronic care patients perceived lower levels of health competence and internal HLC and higher levels of chance HLC than PHE patients. Satisfaction with care was negatively associated with chance HLC in the chronic care group, while health competence was negatively associated with chance HLC in the PHE group. The findings of the current study suggest that although chronic care patients were satisfied with care, they had stronger chance beliefs and weaker beliefs about internal factors. Hence, for better management of rheumatological conditions, it is important to focus on improving patients’ coping skills through effective health education strategies.

Associations of depressive symptoms and psychosocial working conditions with sickness absences in a Finnish cohort of 11,495 employees

ObjectiveTo examine the relevance of questions on psychosocial working conditions and depressive symptoms, as used in a screening questionnaire in preventive occupational health care, to predict repetitive short or long sickness absences. MethodsThe participants were 11,495 employees of various occupations in Finnish companies. The data were prospectively collected by one occupational healthcare service provider (Finla) and included register data of sickness absences and responses to a questionnaire used in pre-employment and periodic health examinations between 2011 and 2019. Long sickness absences of > 30 days and repetitive short sickness absences of one to ten days in a 24-month follow-up were used as outcome variables for multiple logistic regression analysis. ResultsStrong associations were found between repetitive short and long sickness absences, and the questions on depressive symptoms “felt hopeless about the future”, “felt melancholic”, “felt everything was an effort”, and “feelings of worthlessness”. Among questions on psychosocial working conditions, strong associations were found between sickness absences and questions on decision authority, self-reformation opportunities, job versatility, and appreciation for their work. ConclusionsQuestionnaires on depressive symptoms and psychosocial work environment can help identify patients with an increased risk of sickness absence. Data accumulating in occupational health care should be used more systematically to reduce the risk of work disability through targeted occupational health interventions.

A comparison of periodic health examinations and workplace health screening for workers in Singapore and Japan.

This article aims to provide a historical overview of how workplace safety and health legislations in Singapore and Japan have evolved, and perform a comparative analysis of the occupational health systems where work-related medical examinations and health screening are concerned. The discourse is centered on three key themes - coverage, comprehensiveness, and continuity of care. The comparative analysis was performed based on secondary data obtained from open-source platforms. Singapore and Japan have robust workplace safety and health legislative frameworks and laws. However, their approaches diverge because of differing socioeconomic and political contexts. Japan's regulations are generally more comprehensive, require more frequent monitoring of workers' health status, and encompass both physical and mental health components. Singaporean companies focus primarily on the physical component of health, and statutory examinations are required only for exposure to specific occupational hazards. With increasing prominence of mental health issues and shift towards preventive care in Singapore, there will be greater emphasis on a holistic approach to each employee's overall health in future. For Japan, the challenge would be to strike a balance between long-term sustainability of current policies against the need for state and corporations to still retain an adequate stake in ensuring workers' overall health.

Cerebrovascular insult as a consequence of poor health behaviour in patients with schizophrenia and bipolar disorder

IntroductionCerebrovascular insult (CVI) in patients with psychiatric diseases is to a large extent more prevalent and is accompanied by a worse prognosis after a incident. Despite the higher mortality, these patients are less frequently subjected to CT angiography and interventional intervention on the blood vessels of the brain.ObjectivesTo show the frequency of cerebrovascular insults in patients with schizophrenia (SCH), bipolar affective disorder (BP), and depression, depending on age, gender, socioeconomic characteristics, professional qualifications, and dietary habits.MethodsA total of 1200 patients with SCH, BD and depression were treated over a period of five years.Results11.1% SCH patients had CVI and 3,7% a cases of bipolar afective diseases. CVI was most often experienced by patients who were married, employed, or retired, and who lived in urban areas. Smoking, elevated blood pressure values, elevated BMI do not have a significant impact on the occurrence of CVI in all groups. Patients with elevated values of glucose, total cholesterol and LDL cholesterol and CRP had a higher incidence of cerebrovascular insult.ConclusionsIt is necessary to work on raising the awareness of people suffering from psychiatric diseases regarding lifestyle and eating habits, and to conduct periodic health examinations. It is important to recognize high-risk patients and educate them about preventive measures.Disclosure of InterestNone Declared

Make your choice: Angiography or periodical health examination?

Periodical health examination is one of the important factors influencing a healthy lifestyle. Patients undergoing routine physical examination in primary care are included in the scope of preventive medical services, which is the most basic principle of primary care. Identifying the risk factors enables individuals to adopt healthier lifestyle practices. In our study, we examined the correlation between patients undergoing coronary angiography for suspected coronary stenosis and the extent of primary care services they had received in their medical history, along with the severity of stenosis observed during the angiography. Patients were interviewed using a pre-structured questionnaire to gather information about their past utilization of primary healthcare services related to coronary matters and their cardiovascular (CV) risk profile as documented in their medical history. The necessary standard tests for angiography procedures were retrieved from patient records. The SYNTAX score, a tool that aids in the objective assessment of the severity of coronary artery disease (CAD), was computed and documented. This score was then compared with the history of primary care utilization. The patients' utilization of services from the Primary Healthcare Center (PHC) was evaluated using a scoring system, with an average score of 29.27 ± 11.27 out of 100 points (minimum: 20; maximum: 60). The average SCORE Türkiye indicating the 10-year risk of CV events for all patients was calculated as 14.31% ± 8.65% (high-very high risk), while the average SYNTAX score was 15.20 ± 9.97. There was a positive and significant correlation found between fasting blood glucose and creatinine values with both SYNTAX score and SCORE Türkiye (respectively; R = 0.238, P = .013; R = 0.289, P = .002). Factors such as smoking and metabolic syndrome were associated with CAD severity. It important to highlight that individual recommended for angiography had a notably lower utilization of healthcare services from the PHC based on their medical histories. This circumstance has resulted in individuals who do not undergo CV event screenings at PHCs having higher SYNTAX scores, indicating more severe CAD that necessitates angiography. Conducting regular periodical health examinations at PHCs can help mitigate these statistics.

Family history of hypertension enhances age-dependent rise in blood pressure, a 15-year follow-up, the Tampere adult population cardiovascular risk study.

A family history (FH) of hypertension is known to predispose to high blood pressure. We wanted to study whether it associates with blood pressure and hypertension in the Tampere adult population cardiovascular risk 15-year longitudinal study. A 50-year-old Finnish cohort having hypertension and their controls was examined retrospectively. The groups were combined and stratified to 396 subjects with a positive FH of hypertension and 384 with a negative FH. A 15-year follow-up was done from their periodic health examinations at the ages of 35-, 40-, 45-, and 50 years. In follow-up from the age of 35 years, systolic blood pressure (P < .001), diastolic blood pressure (P < .001), and the annual increase of systolic blood pressure (P < .010) were higher in the group with positive FH, compared to the negative FH group. Positive FH associated with diagnosed hypertension by the age of 50 years (OR 3.52, P < .001). The FH groups were not associated with body mass index. Our findings show that the prevalence of hypertension at the age of 50 years was significantly higher in those with a positive FH of hypertension. Asking about FH can provide the clinician with a simple instrument for recognition of subjects at risk of hypertension for closer monitoring at a younger age.

Role and Value of the Corporate Medical Director.

The role of the Corporate Medical Director (CMD) has received increased attention during the COVID-19 pandemic and has continued to evolve. This updated guidance addresses the role and value of the CMD in: health policy, strategy, and leadership; fostering a culture of health and well-being; supporting worker health and productivity/performance; addressing mental health; collaborating on employer benefits design; developing programs for global health, travel medicine, and remote/extreme environments; overseeing on- and near-site clinics; incorporating digital technology, artificial intelligence, and telehealth in health programs; supporting critical incident preparedness and business continuity planning; addressing workplace hazards; and overseeing periodic executive health examinations.

Assessing Individuals Attending the Family Medicine Clinic for Periodic Health Examinations in Screening of Diabetes Mellitus.

This study aims to evaluate the presence and risk of diabetes mellitus (DM) and the factors affecting the risk in those who visited the family medicine outpatient clinic. The present study included adult patients who presented to the outpatient clinic for periodic health examination between February 4, 2022, and April 4, 2022, and who had no known history of DM and were eligible for screening. Anthropometric measurements of the participants were made and their clinical and familial histories were taken in relation to DM. HbA1c and fasting blood glucose (FBG) tests were conducted for each participant. A total of 125 participants, 87 (69.6%) women and 38 (30.4%) men, were included in the study, and five (4%) participants had diabetes. The analysis of the independent risk factors associated with diabetes by multivariate logistic regression analysis revealed that the presence of DM in the family increased the risk of having HbA1c ≥ 5.7% (OR: 3.441; 95% CI: 1.381-8,574; p=0.008). Among women, the waist circumference being > 95 cm was determined as a discriminating factor for HbA1c ≥ 5.7% (sensitivity: 61.54% and specificity: 68.85%). Accurate patient-centered risk assessments by family physicians can lead to positive lifestyle modifications in patients. For this purpose, family physicians should evaluate the patients for diabetes and its associated risk factors and encourage them to take measures in order to prevent diabetes.

Association of Established Primary Care Use With Postoperative Mortality Following Emergency General Surgery Procedures

Sixty-five million individuals in the US live in primary care shortage areas with nearly one-third of Medicare patients in need of a primary care health care professional. Periodic health examinations and preventive care visits have demonstrated a benefit for surgical patients; however, the impact of primary care health care professional shortages on adverse outcomes from surgery is largely unknown. To determine if preoperative primary care utilization is associated with postoperative mortality following an emergency general surgery (EGS) operation among Black and White older adults. This was a retrospective cohort study that took place at US hospitals with an emergency department. Participants were Medicare patients aged 66 years or older who were admitted from the emergency department for an EGS condition between July 1, 2015, and June 30, 2018, and underwent an operation on hospital day 0, 1, or 2. The analysis was performed during December 2022. Patients were classified into 1 of 5 EGS condition categories based on principal diagnosis codes; colorectal, general abdominal, hepatopancreatobiliary, intestinal obstruction, or upper gastrointestinal. Mixed-effects multivariable logistic regression was used in the risk-adjusted models. An interaction term model was used to measure effect modification by race. Primary care utilization in the year prior to presentation for an EGS operation. In-hospital, 30-day, 60-day, 90-day, and 180-day mortality. A total of 102 384 patients (mean age, 73.8 [SD, 11.5] years) were included in the study. Of those, 8559 were Black (8.4%) and 93 825 were White (91.6%). A total of 88 340 patients (86.3%) had seen a primary care physician in the year prior to their index hospitalization. After risk adjustment, patients with primary care exposure had 19% lower odds of in-hospital mortality than patients without primary care exposure (odds ratio [OR], 0.81; 95% CI, 0.72-0.92). At 30 days patients with primary care exposure had 27% lower odds of mortality (OR, 0.73; 95% CI, 0.67-0.80). This remained relatively stable at 60 days (OR, 0.75; 95% CI, 0.69-0.81), 90 days (OR, 0.74; 95% CI, 0.69-0.81), and 180 days (OR, 0.75; 95% CI, 0.70-0.81). None of the interactions between race and primary care physician exposure for mortality at any time interval were significantly different. In this observational study of Black and White Medicare patients, primary care utilization had no impact on in-hospital mortality for Black patients, but was associated with decreased mortality for White patients. Primary care utilization was associated with decreased mortality for both Black and White patients at 30, 60, 90 and 180 days.

Impacts of the COVID-19 pandemic on patients with chronic conditions in Vietnam: A cross-sectional study.

We assess the impact of the COVID-19 pandemic on health, treatment adherence and expectations of patients with chronic diseases in Vietnam. We conducted a national cross-sectional study using a questionnaire survey, distributed through social networks and presented on Google Forms. The survey was performed during two months of the most stringent social distancing in Vietnam (between 21 July and 21 September 2021). Most of the participants said that the COVID-19 epidemic had affected their daily activities (91.9%), health (53.6%), sleep behavior (52.3%), and mental health (79.8%). During social distancing in Vietnam, three-quarter could not go to hospitals for periodic health examination; nearly half of respondents did not do daily physical activity; a quarter of respondents did not adhere to recommended diet plan. Factors associated with the effect of the COVID-19 epidemic on patient's health included those living in Ho Chi Minh City (p = 0.015), lived alone (p = 0.027), uncontrolled chronic conditions (p < 0.001), treatment dissatisfaction or experienced anxiety/stress (p < 0.001). Factors associated with medication adherence included the elderly (p = 0.015), having periodic health examination (p = 0.012), direct consultation (p = 0.003), and telemedicine (p = 0.007). This study highlights the urgent need for better chronic management strategies for the new post-COVID era in the future.

PHILIPPINE GUIDELINES ON PERIODIC HEALTH EXAMINATION: PEDIATRIC IMMUNIZATION

This Clinical Practice Guideline for the Periodic Health Examination (Pediatric Immunization) is an output from the joint undertaking of the Department of Health and National Institutes of Health-Institute of Clinical Epidemiology. This clinical practice guideline is a systematic synthesis of scientific evidence on immunization for the prevention of human papilloma virus (HPV) infection, influenza, typhoid fever, Japanese encephalitis, poliomyelitis, meningococcal infection, and Hepatitis A in the pediatric population. The CPG provides nine (9) recommendations on prioritized questions regarding the relevant vaccines for preventing these seven (7) diseases. Recommendations are based on the appraisal of the best available evidence on each of the eight identified clinical questions. The CPG is intended to be used by general practitioners and specialists in the primary care setting, policy makers, employers and administrators, allied health practitioners and even patients. The guideline development process followed the widely accepted Grading of Recommendations, Assessment, Development, and Evaluation or the GRADE approach including GRADE Adolopment, a systematic process of adapting evidence summaries and the GRADE Evidence to Decision (EtD) framework. , It includes 1) identification of critical questions and critical outcomes, 2) retrieval of current evidence, 3) assessment and synthesis of the evidence base for these critical questions, 4) formulation of draft recommendations, 5) convening of a multi­sectoral stakeholder panel to discuss values and preferences and assess the strength of the recommendations, and 6) planning for dissemination, implementation, impact evaluation and updating. The recommendations in this CPG shall hold and will be updated after 3 years or when new evidence arise.

Risk Profile, Awareness, and Immunization Status of Family Medicine Assistants on the Agents That Can Be Transmitted from the Hospital in the COVID-19 Pandemic

Eighteen months of family medicine residency training is completed as in-hospital rotation. In this process, the increase in the possibility of encountering risky situations in terms of hospital acquired infections (HAI) reveals the importance of awareness and immunization status for family medicine residents in preventing HAI. The aim of this study is to evaluate the risk status of family medicine residents about HAI, to investigate their immunization status, and to raise awareness on this issue. This study was conducted on 285 participants, including family medicine assistants who received residency training at Gülhane Training and Research Hospital between 01.08.2021 and 30.03.2022. In the 17-question survey made to the residents who accepted the study, demographic characteristics of the residents and some other information about the HAI were questioned. Afterwards, whether they encountered risky situations, periodic control examinations of the physicians, and their immunization status were questioned. Questions were asked in the form of a 5-point Likert-type table about the use of personal protective methods and their knowledge level about HAI. The answers given to the Likert type questions were scored as 1 worst and 5 as the best, and the total knowledge level score (minimum-maximum:15-75) was obtained. 180 (63.2%) of the participants were female, 196 (68.8%) were in the 24-29 age range. Of the participants, 99.3% (n=283) COVID-19, 96.5% (n=275) hepatitis B, 93.7% (n=267) tetanus, 39.6% (n=113) pneumococcus, 39.3% (n=112) influenza vaccine. The knowledge level score of female residents was higher (p=0.001). There was a significant difference between the age distribution of the participants and their knowledge level (p=0.033). According to this difference, the average knowledge level scores of the participants in the 24-29 age range were higher (p=0.047). It was determined that female residents HAI as a higher risk for family medicine residents (p=0.026). Participants who considered HAI as a risk for family medicine residents had a higher knowledge level (p=0.043). In our study, it was seen that HAI were evaluated as a risk by family medicine residents. On the other hand, the awareness and knowledge level of resident physicians on this issue was not considered sufficient. It was determined that some of the vaccines of the physicians were more careful with the effect of the COVID-19 pandemic. However, it was observed that they did not pay due attention to the periodic health examinations. In order to increase the awareness of family medicine residents about HAI, lessons on infections that may be risky can be planned in the training curriculum. By ensuring regular periodic controls, physicians can be followed up in terms of occupational health risks. In case of encountering risky situations, the use of personal protective methods is encouraged and regular inspection is recommended.

Low uptake of seasonal influenza vaccination in Al-Jouf region of Saudi Arabia

IntroductionSeasonal influenza is a contagious viral respiratory condition typically occurring in the fall to early spring months of the year globally. The risk of infection from seasonal influenza can be greatly reduced with vaccination. Unfortunately, research has indicated that the seasonal influenza vaccination rate in Saudi Arabia is low. This study assessed the uptake of seasonal influenza vaccination among adults residing in Al-Jouf region, Saudi Arabia. Materials and MethodsA cross-sectional survey targeting adults (20–80 years) residing in Al-Jouf region, Saudi Arabia, was conducted to gather information about their sociodemographic characteristics, chronic conditions, knowledge about periodic health examinations (PHE), regular use of PHE, and uptake of seasonal influenza vaccination. Comparative statistics and a multivariate logistic regression analysis were conducted to determine characteristics associated with the uptake of seasonal influenza vaccination. ResultsA total of 624 respondents completed the survey and participated in this study. Among the participants, 27.4% indicated they visited their primary healthcare centers or hospitals every year to get a seasonal influenza vaccination. The regression analysis showed that the odds of getting a seasonal influenza vaccination were higher among employed respondents (Odds Ratio [OR] = 1.73; P = 0.039), respondents who were employees of the healthcare sector (OR = 2.31; P = 0.001), and those with a higher PHE Knowledge Score (OR = 1.22; P = 0.008), compared to their counterparts. ConclusionsSeasonal influenza is a serious condition warranting appropriate prevention measures, including vaccination. However, this study confirmed low rates of seasonal influenza vaccination in Al-Jouf Region of Saudi Arabia. Interventions to boost vaccination uptake, in particular among unemployed individuals, those not working in the healthcare sector, and those with lower PHE knowledge Scores, are therefore recommended.

Possibilities of lipid clinics in identifying patients with familial hypercholesterolemia

Aim. To assess the detection rate of familial hypercholesterolemia among outpa­tients visiting a lipidologist.Material and methods. We analyzed the causes and nature of lipid metabolism disorders in patients of the Adult Lipidology Center as follows: 1233 people aged 18-84, including 777 women (63,02%) and 456 men (36,98%). Biomaterial samples from 421 patients with the phenotype of definite, possible or probable familial hypercholesterolemia were studied by massive parallel sequencing using a panel of 5 genes associated with familial hypercholesterolemia (LDLR, LDLRAP1, APOB, APOE, PCSK9). For statistical processing, descriptive statistics methods were used.Results. Working-age patients apply 1,56 times more often than patients of the older age group (60,91% vs 39,09%), and the vast majority of them were referred by a primary care physician based on data from periodic health examinations. The mean level of total cholesterol and low-density lipoprotein cholesterol in the lipidology center was 7,58 and 4,8, respectively. Out of 421 samples, 127 patients (10,3% of the total number of patients and 30,16% of the number of biosamples) had previously described variants of the LDLR, APOB and/or PCSK9 genes associated with familial hypercholesterolemia.Conclusion. The detection rate of definite familial hypercholesterolemia ranges from 5,51 to 8,43% of outpatients visiting a lipidologist, while the proportion of verified carriers of gene mutations related to familial hypercholesterolemia is 10,3%. The diagnosis should not be rejected with a formally low probability according to the S. Broom and DLCN criteria, as well as when identifying data suggestive of secondary lipid metabolism disorders.

Blood Pressure Examination Habit and Its Determinants Among Civil Servants in Arba Minch Town: A Cross-Sectional Study - Using Hurdle Poisson Regression Model.

Hypertension is a common non-communicable disease detected through blood pressure measurement that makes periodic health examinations crucial for the detection, prevention, and timely treatment. To assess the frequency of blood pressure examination and its determinant among civil servants in Arba Minch Town, south Ethiopia. From February to March 2020 an organization-based cross-sectional study design was employed among civil servants in Arba Minch town. Data were collected from 580 randomly selected civil servants using a well-structured questionnaire. Hurdle Poisson regression model was conducted to identify determinants of frequency of blood pressure examination using R version 4.0.2. A total of 407 (70.2%) civil servants had never examined their blood pressure within a year before the study time. The mean frequency of blood pressure examination was 0.71 with a standard deviation of 1.46. The hurdle Poisson regression analysis indicates age above 40 years (IRR = 6.11, p < 0.001), elevated blood pressure (IRR = 1.48, p < 0.001), no family history of hypertension (IRR = 0.59, p < 0.001) had significant effects on the expected number of non-zero counts blood pressure examination. And education status (OR; 2.39, p < 0.05), poor knowledge about hypertension, not getting advice from health professionals (OR = 8.93, p < 0.001), and age above 40 years had significant effects on not taking blood pressure examination. The frequency of blood pressure examinations among civil servants was found to be low. This study reveals age, elevated blood pressure, family history of hypertension, getting advice, and knowledge on hypertension were found to be determinants of the frequency of blood pressure examination. Thus, concerned health authorities and medical workers should work on these factors to prevent and detect hypertension among apparently healthy civil servants.

Obesity and Its Association with Undiagnosed Diabetes Mellitus, High Blood Pressure and Hypercholesterolemia in the Malaysian Adult Population: A National Cross-Sectional Study Using NHMS Data.

This study aimed to report the prevalence of obesity, classified using Asian cut-off, and its relationships with undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia. We analyzed the nationally representative data from 14,025 Malaysian adults who participated in the NHMS 2015. The relationship between obesity and undiagnosed diabetes mellitus, high blood pressure, and hypercholesteremia was determined using multivariable logistic regressions, and lifestyle risk factors and sociodemographic characteristics were adjusted. The undiagnosed high blood pressure group showed the highest proportionate of overweight/obese (80.0%, 95% CI: 78.1-81.8) and central obesity (61.8%, 95% CI: 59.3-64.2). Inverse association was observed between underweight with undiagnosed high blood pressure (aOR: 0.40, 95% CI: 0.26-0.61) and hypercholesterolemia (aOR: 0.75, 95% CI: 0.59-0.95) groups. In contrast, positive relationships were shown between overweight/obese and risk of undiagnosed diabetes mellitus (aOR: 1.65, 95% CI: 1.31-2.07), high blood pressure (aOR: 3.08, 95% CI: 2.60-3.63), and hypercholesterolemia (aOR: 1.37, 95% CI: 1.22-1.53). Likewise, central obesity was positively associated with a risk of undiagnosed diabetes mellitus (aOR: 1.40, 95% CI: 1.17-1.67), high blood pressure (aOR: 2.83, 95% CI: 2.45-3.26), and hypercholesterolemia (aOR: 1.26, 95% CI: 1.12-1.42). Our findings indicated the importance of periodical health examinations to assess the risk of non-communicable diseases among the general and abdominal obese Malaysian adults.

EVALUATION OF MEMBRANE AND SOLUBLE PD-L1 EXPRESSION IN ADVANCED-STAGE NON-SMALL CELL LUNG CANCER PATIENTS

Objectives: To evaluate membrane and soluble PD-L1 expression in advanced-stage non-small cell lung cancer (NSCLC) patients. Subjects and methods: A prospective, cross-sectional study on 50 advanced-stage NSCLC patients treated at the Respiratory Center, Military Hospital 103 from January to September 2019; the control group consists of 30 normal people who had personal periodic health examination at the Outpatient Department, Military Hospital 103. Membrane PD-L1 (mPD-L1) expression assay was carried out applying immunohistochemistry on cancer tissue samples, using PD-L1 73 - 10 antibody. The serum level of soluble PD-L1 (sPD-L1) was measured using the ELISA technique. Results: 62% of lung cancer tissue samples were positive for mPD-L1 (TPS ³ 1%), of which 51.6% were highly positive and 48.4% low positive. The concentration of sPD-L1 in NSCLC group was significantly higher than that of the control group (2.11 ± 1.48 and 0.73 ± 0.57 ng/mL; p &lt; 0.001). sPD-L1 concentration in the mPD-L1 negative group (1.61 ± 1.37 ng/mL) was statistically significantly lower than that in the mPD-L1 positive group (2.42 ± 1.49 ng/mL) (p = 0.03). At the cut-off value of 1.815 ng/mL, sPD-L1 had a diagnostic value for mPD-L1 positive with a sensitivity of 65% and specificity of 68%, area under the curve was 0.678 (95% CI: 0.521 - 0.835; p = 0.036). Conclusion: The rate of mPD-L1 positive expression in NSCLC tissue was 62%. The concentration of sPD-L1 in NSCLC patients was significantly higher than that in the control group. No significant relationship was found between the two forms of PD-L1 expression.