Periodic Health Examination Research Articles

Positive Association of the JAG1 rs1327235 Genotype with Coronary Artery Disease in Men, the Tampere Adult Population Cardiovascular Risk Study

Aims: The intronic single nucleotide polymorphism rs1327235 (A>G) close to the JAG gene has been implicated to be involved in blood pressure physiology in a genome-wide association study. We wanted to study whether it was associated with hypertension and coronary artery disease (CAD) in the Tampere adult population cardiovascular risk study. Materials and Methods: We analyzed a Finnish periodic health examination cohort of 191 men with diagnosed hypertension and 295 controls. Samples were genotyped for the JAG1 rs1327235 polymorphism using Competitive Allelic Specific PCR (KASP). The incidence of CAD was determined by self-report and the National Hospital Discharge Registry (HILMO). Results: There was no association between the JAG1 rs1327235 genotypes with hypertension at the age of 50 years. However, when the subjects were followed to the age of 60 years, those with the genotype GG had a higher prevalence of CAD (17.9%), compared with the A-allele (9.7%) (p = 0.036). When prevalence of CAD was adjusted by body mass index and total cholesterol, the OR for GG genotype was 2.19 (p = 0.029, confidence interval 1.084 - 4.429) compared with A-allele carriers. In addition, the GG genotype was associated with higher total cholesterol and low-density lipoprotein-cholesterol values, compared with the A-allele. Conclusions: Our findings suggest that the variations in JAG1 rs1327235 may be involved in CAD and cholesterol metabolism.

Screening For Colorectal Cancer in the Age of Simulation Models: A Historical Lens

Screening For Colorectal Cancer in the Age of Simulation Models: A Historical Lens

Evaluation of Periodic Health Examination Follow-up Process of Information and Document Management Employees

Henüz bir hastalık belirtisi göstermeyen sağlıklı kişilerin, tarama, muayene ve laboratuvar testleri ile danışmanlık ve sağlık okuryazarlığı eğitimi yoluyla, sağlıklarının korunmasına katkıda bulunmak amacıyla yapılan ve düzenli bir sağlık kontrolü olan Periyodik Sağlık Muayenesi (PSM), bireylerde sağlık risk faktörlerinin belirlenmesi ve tedavi edilebilir hastalıkların erken evrede teşhisi ile hastalık oranlarının azaltılmasını ifade etmektedir. Türkiye’de PSM Aile Hekimliği hizmetinin görevleri arasında olup, ülkemizde gerek PSM ile yapılan çalışmalar ve gerekse BBY çalışanlarının sağlık durumlarını değerlendirmeleri ve koruyucu sağlık uygulamaları ile ilgili bilgilerini gösteren bilimsel çalışmalar açısından oldukça kısıtlı ya da yetersizdir.Bu araştırmanın amacı, “Aile Hekimliği Uygulamasında Önerilen Periyodik Sağlık Muayeneleri ve Tarama Testleri” kılavuzundan yararlanılarak oluşturulan anket soruları ile 18-65 yaş arası Bilgi ve Belge Yönetimi çalışanlarının periyodik muayenelerini nasıl takip ettiklerini değerlendirmektir. Çalışmanın araştırma türü kesitsel tanımlayıcı bir çalışmadır. Araştırmanın örneklemini, Türkiye’deki bilgi ve belge merkezi çalışanları oluşturmaktadır. Veri toplama aşamasında, 25 Şubat- 30 Nisan 2019 tarihleri arasında örneklemi 693 olan bilgi ve belge merkezi çalışanı anket formunun tamamını yanıtlamıştır. Katılımcıların unvanları akademik personel, arşiv destek elemanı, arşiv sorumlusu, arşiv uzman ve uzman yardımcısı, kütüphane yöneticisi (daire başkanı, müdür, direktör) kütüphaneci ve memur olup, çalıştıkları kurumlar halk ve belediye kütüphaneleri, üniversite kütüphaneleri, okul kütüphaneleri ile diğer kamu ve özel kurumlara ait kütüphaneler ve arşivlerdir. Elde edilen verilerin dağılımına uygun olarak demografik özellikler, çalışanların ailede ve kendilerindeki kanser ve kronik hastalık durumu, çalışanın PSM farkındalığı ve PSM Takip Bilgi Sistemi açısından vermiş oldukları yanıtlar, istatistiksel olarak değerlendirilmiştir. SPPS istatistik programında frekans dağılımları, bağıntı analizleri ve tanımlayıcı analizleri yapılmış, sonuçlar p<.05 anlamlılık düzeyine göre değerlendirilmiştir. Araştırmanın bulguları, BBY çalışanlarının periyodik muayeneler ile ilgili farkındalığını ortaya koymuştur. Kronik, hastalıkların ve kanserin erken teşhisinde önemli etkisi olan periyodik muayeneleri takip etmeyenlerin takip etmeme sebepleri değerlendirilmiştir. Ayrıca bu konudaki farkındalıklarını arttırmak ve periyodik olarak yaptırmaları gereken muayene ve sağlık taramalarını takip etmelerini sağlamak için izlenmesi gereken politikalara yönelik veriler toplanmıştır.Araştırma sonuçları BBY çalışanlarının Periyodik Sağlık Muayene farkındalıklarının yetersiz olduğunu ortaya koymaktadır. BBY çalışanlarının %80,5’i Türkiye’de uygulanan Periyodik Sağlık Muayeneleri (PSM) öneri rehberi hakkında bilgi sahibi değildir. %68,1’i takip etmeleri gereken muayene ve tetkikleri bilmemekte ve %76,8’i takip etmeleri gereken muayene ve tetkikleri düzenli olarak yaptırmamaktadır. Bu çalışmada elde edilen verilerde BBY çalışanlarının PSM bilgi seviyelerinin yeterli olmadığı, PSM takip sürecini bilmedikleri ve bu konuda yeterli sağlık okuryazarlık bilgisine sahip olmadıkları görülmüştür. Bu çalışma ile BBY çalışanlarının periyodik olarak takip etmeleri gerekli sağlık muayenelerini takip edebilmelerine yönelik sağlık okuryazarlıklarının arttırılması, yaşam kalitelerinin yükseltilmesi, koruyucu sağlık hizmetlerinden etkin şekilde yararlanabilmeleri hususunda politika belirlenmesi konusunda öncülük edilmesi hedeflenmektedir.

Erişkinlerin Aile Sağlık Merkezlerine periyodik sağlık muayenesine dair başvuru sıklıklarının ve hizmet alma durumlarının değerlendirilmesi

Erişkinlerin Aile Sağlık Merkezlerine periyodik sağlık muayenesine dair başvuru sıklıklarının ve hizmet alma durumlarının değerlendirilmesi

The Value of Preseason Screening for Injury Prediction: The Development and Internal Validation of a Multivariable Prognostic Model to Predict Indirect Muscle Injury Risk in Elite Football (Soccer) Players

BackgroundIn elite football (soccer), periodic health examination (PHE) could provide prognostic factors to predict injury risk.ObjectiveTo develop and internally validate a prognostic model to predict individualised indirect (non-contact) muscle injury (IMI) risk during a season in elite footballers, only using PHE-derived candidate prognostic factors.MethodsRoutinely collected preseason PHE and injury data were used from 152 players over 5 seasons (1st July 2013 to 19th May 2018). Ten candidate prognostic factors (12 parameters) were included in model development. Multiple imputation was used to handle missing values. The outcome was any time-loss, index indirect muscle injury (I-IMI) affecting the lower extremity. A full logistic regression model was fitted, and a parsimonious model developed using backward-selection to remove factors that exceeded a threshold that was equivalent to Akaike’s Information Criterion (alpha 0.157). Predictive performance was assessed through calibration, discrimination and decision-curve analysis, averaged across all imputed datasets. The model was internally validated using bootstrapping and adjusted for overfitting.ResultsDuring 317 participant-seasons, 138 I-IMIs were recorded. The parsimonious model included only age and frequency of previous IMIs; apparent calibration was perfect, but discrimination was modest (C-index = 0.641, 95% confidence interval (CI) = 0.580 to 0.703), with clinical utility evident between risk thresholds of 37–71%. After validation and overfitting adjustment, performance deteriorated (C-index = 0.589 (95% CI = 0.528 to 0.651); calibration-in-the-large = − 0.009 (95% CI = − 0.239 to 0.239); calibration slope = 0.718 (95% CI = 0.275 to 1.161)).ConclusionThe selected PHE data were insufficient prognostic factors from which to develop a useful model for predicting IMI risk in elite footballers. Further research should prioritise identifying novel prognostic factors to improve future risk prediction models in this field.Trial registrationNCT03782389

Gender aspects of cardiac and carotid arteries remodeling and estimation of load test in watch workers in the Arctic

Objective.To define gender aspects of subclinical atherosclerosis and evaluate interrelation of cardiac and carotid arteries (CA) remodeling with the results of the load test in the watch workers in the Arctic.Design and methods.Within a periodic health examination during one year, 743 males and 213 females doing watch work in the Arctic were examined selectively. CA ultrasound examinations, echocardiography treadmill test and 24-hour blood pressure (BP) monitoring were performed.Results.In the northern watch conditions, the rate of random thickening of intima-media complex (IMC) is equal in males and females and is related to age. Atherosclerotic plaques (AP) in CA were found twice more often in males than in females. In males, IMC thickening correlated with age, watch work duration and BP, whereas AP presence was also associated with left ventricular (LV) remodeling type, 24-hour BP profile and poorly with treadmill test results. CA structure alterations in females were influenced by age and LV remodeling only. Normal average BP was found in hypertensive patients (34,9 % males and 42,1 % females) according to 24-hour BP monitoring. Log-linear analysis showed association between AP in CA lumen and average daily BP in males (by 19,5 %) and in females (by 1,1 %).Conclusions.In the northern watch conditions, subclinical carotid atherosclerosis has significant gender differences and is present twice more often in males than in females. It is associated with age, 24-hour BP profile and mildly with office and average daily BP, significantly with LV concentric hypertrophy and concentric remodeling and poorly with treadmill test results. Further studies are required to find key determinants of the atherosclerosis to decrease cardiovascular risk in the Arctic watch workers.

Factor Analysis of Metabolic Syndrome in Aged Population Undergoing Periodical Health Examinations

Background: Metabolic syndrome (MetS) is a common health problem in aged people. The cluster of diseases associated with MetS, namely, heart disease, cerebrovascular disease, diabetes, hypertensive disease and renal disease, had made a death rate of 0.17%, higher than 0.15% attributed to cancers.Aims: To investigate the prevalence, incidence and reversion rate of MetS in Aged population undergoing periodical health examinations, as well as the associated impact factors.Results: The prevalence of MetS was found to be 19.9% among all the subjects studied, to be higher in female (23.1%) than in male (18.3%). The incidence of MetS was 17.6%. In contrast, the reversion rate of MetS was 45.0%. Sex (p = 0.045) and history of hyperlipidemia (p = 0.006) were two factors found to be significantly associated with the reversion rate of MetS.Conclusion: Physical examinations may help early detect diseases and revise high risk factors timely. Compared with the ordinary older population, those undergoing periodical health examinations tended to have lower incidence of MetS, better health status and higher disease reversion rate than incidence. To sum up, individualized health education and guidance is an imperative and critical nursing intervention to ensure a healthy state for aged population.

The establishment of neuron-specific enolase reference interval for the healthy population in southwest China

To investigate and establish a reference interval (RI) of neuron-specific enolase (NSE) in southwest China’s healthy population by using the laboratory information system database. A total of 86957 periodic health examination individuals of the medical examination center in West China Hospital from 2016 to 2018 were included in the study. We used the Box-Cox conversion combined with the Tukey method to normalize the data and eliminate the outliers, and the normal distribution method and the nonparametric method to estimate the 95% distribution RI. The NSE 95% distribution RI we established in healthy populations in southwest China through normal distribution and nonparametric method were 0–19.64 ng/ml and 0–20.46 ng/ml, respectively. The obtained RIs verification conformed to the standard and was significantly different from the reagent instruction(P < 0.05). The RI established by the nonparametric method was superior to the RI of the normal distribution method and reagent instruction(P < 0.05). We initially established an NSE RI that was suitable for the healthy southwest China population. The Box-Cox conversion combined with the Tukey method and nonparametric method is a reliable and straightforward indirect method for reference interval acquisition, which is suitable for the promotion and application of clinical laboratory.

Principles of formation of risk groups among employees at the enterprise in the Leningrad region

Generalized experience in a large enterprise, in which stood a group of workers requiring additional medical care after periodic health examination.

The incidence of insomnia among employed and unemployed individuals

Abstract Introduction: Insomnia is a complex disorder and requires knowledge of the subjective feelings of the patient. The incidence of insomnia varies depending on the classification and definition used in the study, and usually oscillates between 4–48%. Insomnia lowers quality of life (QoL), which translates into poorer functioning at social and professional levels. The aim of this study was to determine the incidence of insomnia among employed and unemployed individuals with regard to their sociodemographic and socioeconomic data, to analyze the relationship between insomnia, depressive symptoms and chronic diseases, and to assess how insomnia affects QoL. Materials and methods: This survey-based study included 597 people. The following questionnaires were used: the Athens Insomnia Scale (AIS), Beck’s Depression Inventory (BDI), the Short Form 36 Health Survey (SF-36), and a self-developed questionnaire. Results: Insomnia was found in 17.75% (n = 106; p ≤ 0.001) of respondents. There was a statistically significant relationship between insomnia and sex (p = 0.006). Insomnia was more common in women (20.83%; n = 75), people over 56 years of age (27.08%; n = 26; p ≤ 0.001), and those unemployed (26.37%; n = 53; p ≤ 0.001). A statistically significant relationship was demonstrated between depression and insomnia assessed by the AIS (p ≤ 0.001). Conclusions: 1. Insomnia was more common in unemployed individuals. 2. Insomnia was more common in those with hyper-tension, irrespective of their employment status. Therefore, primary care physicians should use the AIS as part of screening among chronically ill patients. 3. Insomnia was accompanied by depressive symptoms in all groups analyzed in this study, irrespective of their employment status. 4. Insomnia is a serious public and mental health problem. The AIS should be used as part of workers’ periodic health examinations, since ignoring the problem of insomnia decreases QoL.

Cancer Prevention Using Machine Learning, Nudge Theory and Social Impact Bond.

There have been prior attempts to utilize machine learning to address issues in the medical field, particularly in diagnoses using medical images and developing therapeutic regimens. However, few cases have demonstrated the usefulness of machine learning for enhancing health consciousness of patients or the public in general, which is necessary to cause behavioral changes. This paper describes a novel case wherein the uptake rate for colorectal cancer examinations has significantly increased due to the application of machine learning and nudge theory. The paper also discusses the effectiveness of social impact bonds (SIBs) as a scheme for realizing these applications. During a healthcare SIB project conducted in the city of Hachioji, Tokyo, machine learning, based on historical data obtained from designated periodical health examinations, digitalized medical insurance receipts, and medical examination records for colorectal cancer, was used to deduce segments for whom the examination was recommended. The result revealed that out of the 12,162 people for whom the examination was recommended, 3264 (26.8%) received it, which exceeded the upper expectation limit of the initial plan (19.0%). We conclude that this was a successful case that stimulated discussion on potential further applications of this approach to wider regions and more diseases.

ON THE REFERENCE STANDARDS FOR PUPILLOMETRYON A COMPUTER COMPLEX FOR RECORDING AND ASSESSMENT OF THE PUPILLARY RESPONSE

It was noted that the reference standards for pupil diameter, amplitude, time and speed parameters of pupil reactions in practically healthy people (889 men and 1103 women, aged from 20 to 70 years), who underwent planned medical examinations on the certified digital automated binocular pupillometric complex KSRZRts-01, showed age dynamics. With age, both the pupil diameter and the amplitude and speed of the pupil reaction decreased. The development of reference standards for pupil diameter and a complex of pupillometry parameters, including their age dynamics, is necessary for the analysis of pupillometry data in the practice of periodic occupational health examinations, neurology, occupational pathology, sports medicine, and narcology to assess the functional state of the autonomic nervous system.

Cross-sectional study of associations between normal body weight with central obesity and hyperuricemia in Japan

BackgroundSeveral studies have shown that normal weight with central obesity (NWCO) is associated with cardiovascular disease risk factors such as hypertension, dyslipidemia and diabetes. However, the relationship between NWCO and hyperuricemia has not been studied in detail.MethodsWe investigated the association between NWCO and hyperuricemia among Japanese adults aged 40–64 years who had undergone periodic health examinations between April 2013 and March 2014. Obesity was defined as a body mass index (BMI) ≥25 kg/m2 and central obesity was determined as a waist-to-height ratio (WHtR) ≥0.5. We classified the participants into the following groups based according to having obesity and central obesity: normal weight (BMI 18.5–24.9 kg/m2) without (NW; WHtR < 0.5) and with (NWCO) central obesity, and obesity without (OB) and with (OBCO) central obesity. Hyperuricemia was defined as serum uric acid > 7.0 and ≥ 6.0 mg/dL in men and women, respectively, or under medical treatment for hyperuricemia. Alcohol intake was classified as yes (daily and occasional consumption) and none (no alcohol consumption). Odds ratios (OR) and 95% confidence intervals (CI) for hyperuricemia were calculated using a logistic regression model.ResultsWe analyzed data derived from 96,863 participants (69,241 men and 27,622 women). The prevalences of hyperuricemia in men and women were respectively, 21.4 and 11.0%, and of participants with NWCO respectively 15.6 and 30.0%. The adjusted OR for hyperuricemia was significantly increased in OBCO compared with NW, regardless of sex (men: OR, 2.12; 95%CI; 2.03–2.21; women: OR, 3.54; 95%CI, 3.21–3.90) and were statistically significant in NWCO compared with NW (men: OR, 1.44; 95%CI, 1.36–1.52; women: OR, 1.41; 95%CI, 1.27–1.57). The results were similar regardless of alcohol consumption.ConclusionsWe found that NWCO and OBCO were associated with hyperuricemia in middle-aged Japanese men and women. Middle-aged Japanese adults with normal weight but having central obesity should be screened using a combination of BMI and WHtR and educated about how to prevent hyperuricemia.

Evaluation of 90 kV Beam with 0.15 mm Cu Filter in Chest Radiography Using CsI-flat Panel Detector

To compare the visibility of anatomic structure in chest radiography acquired with different beam quality (120 kV beam and 90 kV beam with 0.15 mmCu) using CsI-flat panel detector. Pair image obtained by different beam quality of 100 person's chest radiographies which were taken periodical health examination were compared with the visibility of normal structures (pulmonary vessels) and abnormal opacities by two pulmonologists and four radiological technologists. Moreover, the spectrum of the two beam quality were calculated using Monte Carlo simulation. Dominant observers gave high score significantly (p<0.01) to the 90 kV beam's image in spite of 20% less dose. Monte Carlo simulation showed that 90 kV beam with 0.15 mmCu were much absorbed primary photon than 120 kV beam to CsI detector, and less absorbed secondary photon. The visibility of anatomic structure and abnormal opacities in FPD chest radiography was improved by using the 90 kV beam with 0.15 mmCu than traditional 120 kV beam's chest radiography.

Revisión sistemática y análisis comparativo de las herramientas de tamizaje nutricional en pediatría validadas en Europa y Canadá

Introducción. El tamizaje nutricional es una herramienta efectiva que permite establecer el riesgo de desnutrición hospitalaria, por consiguiente es importante revisar las directrices respecto a su uso en pediatría.Objetivo. Ofrecer recomendaciones sobre el uso de las herramientas de tamizaje nutricional validadas en Canadá y Europa en población colombiana. Materiales y métodos. Se realizó una revisión sistemática siguiendo la metodología PRISMA. Para la evaluación de la calidad de la evidencia se utilizó la herramienta U.S Preventive Services Task Force, formulada para medir acciones preventivas por la Canadian Task Force on the Periodic Health Examination.Resultados. Se incluyeron 15 estudios que cumplían los criterios de selección y se identificaron 7 herramientas (PYMS, iPYMS, PeDiSMART, PNR, STAMP, PMST y STRONGkids). Según los lineamientos de la Sociedad Europea de Nutrición Clínica y Metabolismo, la PYMS, la iPYMS y la STRONGkids evalúan simultáneamente variables pronósticas como estado nutricional actual, estabilidad, progresión esperada e influencia de la enfermedad. En cuanto a validez concurrente, el análisis de datos muestra que la PYMS, la iPYMS y la PMST tienen sensibilidades &gt;85% y que la PYMS tiene especificidad &gt;85%. Respecto a reproducibilidad, la PEDISMART, la STRONGkids, la STAMP y la PYMS tienen una concordancia inter-observadores aceptable (k&gt;0.41).Conclusión. Según la evidencia analizada en términos de variables pronósticas, validez concurrente y reproducibilidad, se sugiere el empleo en la práctica clínica de la herramienta PYMS, mientras que para el uso de la STAMP y la iPYMS las instituciones deben evaluar su aplicabilidad.

Periodic Health Examination Knowledge, Attitudes and Behavior among Primary Care Physicians: A Descriptive Study of Preventive Care in Turkey

Aim: Primary care physicians play an important role in&#x0D; providing the services of health counseling, and early disease diagnosis. This&#x0D; study aims to reveal the practice status of periodic health examinations (PHE),&#x0D; influencing factors and primary care clinicians’ knowledge, attitudes and&#x0D; behavior about PHE in Turkey. Materials-Methods:&#x0D; The study was conducted between December 2014 and April 2015 with the&#x0D; participation of 629 family medicine specialists and general practitioners,&#x0D; randomly selected through stratified sampling from all 7 geographical regions&#x0D; in Turkey. Physicians were asked to answer the questionnaire on a face to face&#x0D; manner (response rate %100). Besides 17 questions on socio-demographic items&#x0D; and specifications of PHE, the questionnaire consists of 12 questions including&#x0D; 4 knowledge, 4 attitudes, 2 behavior, and 2 questions on preferences. Results: Of the respondents 19.4% were&#x0D; specialists, and 55.3% of all physicians applied PHE periodically. However,&#x0D; 68.4% of respondents stated that PHEs are insufficiently applied in primary&#x0D; care and %37 think that the rates of PHEs would increase when registered&#x0D; patient population per physician would decrease. Specialists were significantly&#x0D; more applying PHE and had significantly more correct answers regarding knowledge,&#x0D; attitude and behavior questions (p&amp;lt;0.05). Physicians working in regions with&#x0D; higher socioeconomic levels had significantly more correct answers regarding&#x0D; knowledge about PHE (p&amp;lt;0.001). However, attitude and behavior levels on PHE&#x0D; in socioeconomically compromised regions like South-Eastern Anatolia and Black&#x0D; Sea Region were significantly lower (p&amp;lt;0.001). Our study suggests that&#x0D; special training on PHE does not play a decisive role in using PHE in daily&#x0D; practice (p&amp;gt;0.05).&amp;nbsp;Amaç: Aile hekimleri sağlık danışmanlığı, hastalıkların erken&#x0D; tanısı ve birinci basamak sağlık hizmetlerinin etkili sunulmasında önemli bir yere sahiptir. Bu çalışmanın amacı birinci basamak sağlık&#x0D; hizmetlerinde Periyodik Sağlık Muayenelerinin (PSM) uygulanma durumu ve&#x0D; etkileyen faktörler ile PSM hakkında birinci basamak&#x0D; klinisyenlerinin bilgi, tutum ve davranışlarının belirlenmesidir. Gereç-Yöntem: Tanımlayıcı tipteki bu çalışma Aralık 2014&#x0D; ile Nisan 2015 arasında Türkiye Cumhuriyeti’ni&#x0D; temsil eden 7 coğrafi bölgeden tabakalı örneklem&#x0D; yöntemi ile belirlenen 629 aile&#x0D; hekimliği uzmanı ve aile hekimliği sertifikalı pratisyen hekimin katılımıyla&#x0D; yürütülmüştür. Aile hekimlerinden anketi yüz yüze cevaplamaları istenmiştir&#x0D; (katılım oranı %100). Sosyodemografik öğeler ve PSM'nin özellikleri hakkındaki 17 soru&#x0D; dışında, anket 4 bilgi, 4 tutum, 2 davranış ve 2 soru da tercihlerle ilgili&#x0D; olmak üzere 12 sorudan oluşmaktadır. Bulgular: Katılımcıların %19,4’ü aile&#x0D; hekimliği uzmanıdır ve tüm aile hekimlerinin %55,3’ü periyodik olarak PSM&#x0D; yapmaktadır. Bununla birlikte, katılımcıların%68,4'ü birinci&#x0D; basamakta PSM'lerin yetersiz uygulandığını ve %37'si de doktor başına kayıtlı&#x0D; hasta popülasyonu azaltıldığında PSM oranlarının artacağını düşündüğünü&#x0D; belirtmiştir. Uzmanlar&#x0D; PSM'yi önemli ölçüde daha fazla uyguluyorlardı ve bilgi, tutum ve davranış sorularına&#x0D; önemli ölçüde daha doğru cevap vermişlerdir (p &amp;lt;0.05). &amp;nbsp;Sosyoekonomik&#x0D; düzeyi daha yüksek olan bölgelerde çalışan hekimlerin PSM konusunda bilgi ile&#x0D; ilgili sorulara daha doğru cevap vermişlerdir (p &amp;lt;0.001). Ancak, Güneydoğu&#x0D; Anadolu ve Karadeniz Bölgesi gibi sosyoekonomik açıdan düşük bölgelerde PSM'ye&#x0D; yönelik tutum ve davranış düzeyleri anlamlı derecede düşüktür (p &amp;lt;0.001). Çalışmamız PSM konusunda özel eğitimlerin günlük pratikte&#x0D; PSM uygulamasında belirleyici bir rol oynamadığını düşündürmektedir (p&amp;gt;&#x0D; 0.05).

Association of the Collagen Type IV Alpha 1 Chain Gene rs3783107 GG Genotype with Hypertension, Asthma, and Eczema: The Tampere Adult Population Cardiovascular Risk Study.

Aims: Basement membranes (BMs) provide structural support to tissues, and also offer functional input to modulate cellular function. Type IV collagen is the most abundant protein in BMs. The collagen type IV alpha 1 chain (COL4A1) gene variant rs3783107 G > A has previously been associated with intracranial aneurysms. We examined this polymorphism's association with cerebrovascular events in the Tampere adult population cardiovascular risk study, and also evaluated its association with hypertension, asthma, and long-term eczema in this population. Materials and Methods: A Finnish periodic health examination (PHE) cohort of 331 subjects with diagnosed hypertension and 440 normotensive controls was analyzed. DNA was extracted from buccal swabs. Genotyping was performed using KASP (competitive allelic-specific amplification). Prevalence of hypertension, asthma, or long-term eczema was obtained from the PHE. The incidences of cerebrovascular diseases and transient cerebral ischemic attacks was obtained from the National Hospital Discharge Registry (HILMO). Results: Even after adjusting for body mass index class and gender, subjects with the rs3783107 major genotype GG had significantly more hypertension (OR [odds ratio] = 1.38, 95% CI [confidence interval]: 1.01-1.87, p = 0.043), asthma (OR = 2.78, 95% CI: 1.25-6.19, p = 0.012), and eczema (OR = 2.00, 95% CI: 1.08-3.70, p = 0.027) than those with the A allele. Furthermore, subjects with the GG genotype had significantly higher systolic (p = 0.026) and diastolic blood pressure (p = 0.013) that those with the A allele. Variant rs3783107 did not significantly associate with cerebrovascular events. Conclusions: Our findings suggest that there are genotype-phenotype associations between the COL4A1 gene variant rs3783107 and hypertension, asthma, and eczema.

Questionnaire and biomarker-based risk assessment of alcohol abuse among persons receiving various levels of medical professional education

Aim. To compare the results of the questionnaire and biomarker-based risk assessment of alcohol abuse among persons receiving higher and mid-level medical professional education.&#x0D; Methods. Among students of mid-level and higher medical education age 18 to 27 years (77 and 124 subjects, respectively), activity of indicator enzymes was measured in blood serum, and with the help of questionnaires the risk of alcohol abuse (CRAFFT, CAGE, AUDIT) and psychological features of the person were determined [A.G. Zverkovs and E.V. Eidmans questionnaires of willpower and self-control, R. Baumeisters self-control questionnaire, hardiness survey (Maddi S.R.) adapted by D.A. Leontyev, Barratt Impulsiveness Scale Test, test for revealing risk groups of psychoactive drug abuse in the educational institution]. Statistical significance was assessed with the use of nonparametric statistics.&#x0D; Results. The activity of enzymes (aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase) in the blood of the subjects did not have significant intergroup differences. Additionally (beyond this study), we characterized the database of laboratory tests of the students aged 18 to 27 years seeking medical care in the academic center of laboratory diagnosis of Omsk State Medical University. Among 646 subjects, 52 (8.1%) had laboratory analyses exceeding the reference so the differences were expected. Absence of results exceeding reference values of the activity of the studied enzymes was necessary in our study to confirm the absence of pathology associated with cytolysis as well as the signs of chronic alcohol abuse with harmful consequences, which is equivalent to meeting the inclusion criteria (absence of pathology according to medical professional consultation report 086/u and to the results of periodic health examination). Among all surveyed, the CRAFFT questionnaire showed a 2.7-fold higher number of groups at risk of alcohol abuse than CAGE and 1.4 times more than AUDIT. The results of CAGE and CRAFFT test questionnaires showed a greater prevalence of the risk of alcohol abuse among students of higher medical education programs compared to those receiving mid-level medical education (CAGE by 2.7 times; CRAFFT by 1.68 times) . The AUDIT test revealed no statistically significant differences between the groups (p=0.093). Analysis of the results of psychological testing to identify the propensity for addictive behavior, showed a weak correlation with self-control (r=0,406, p=0,014 and r=0,313, p=0,016 for CRAFFT and AUDIT, respectively). Correlation between the self-control violation and risk of alcohol abuse was quite weak according to the results, hence, the students with disordered self-control are not alwaysa characterized by alcohol motivation. In the context of our received data, psychological survey for monitoring the risk of abuse cannot substitute CRAFFT and AUDIT tests.&#x0D; Conclusion. The CRAFFT questionnaire is most effective in assessing the risk of alcohol abuse in a population of young people; the results of the questionnaires used weakly correlated with tests that reflect the psychological characteristics of the person; the activity of the studied enzymes in the blood serum of did not correlate with the results of surveys and is within the population reference interval.

Associations between normal weight central obesity and cardiovascular disease risk factors in Japanese middle-aged adults: a cross-sectional study

BackgroundSeveral studies have shown that normal weight central obesity (NWCO) is associated with cardiovascular disease (CVD) risk factors. However, studies conducted in the Japanese population have been very limited. Thus, the relationships between normal weight central obesity, classified using body mass index (BMI), the waist-to-height ratio (WHtR), and CVD risk factors in middle-aged Japanese adults were investigated.MethodsThe participants were Japanese adults aged 40–64 years who had undergone periodic health examinations in Japan during the period from April 2013 to March 2014. The participants were categorized into the following four groups: normal weight (BMI 18.5–24.9 kg/m2) and no central obesity (WHtR < 0.5) (NW); normal weight and central obesity (WHtR ≥ 0.5) (NWCO); obesity (BMI ≥ 25 kg/m2) and no central obesity (OB); and obesity and central obesity (OBCO). Hypertension was defined as systolic blood pressure ≥ 140 mmHg, diastolic blood pressure ≥ 90 mmHg, or taking medication for hypertension. Dyslipidemia was defined as LDL-C ≥ 140 mg/dl, HDL-C < 40 mg/dl, triglyceride ≥ 150 mg/dl, or taking medication for dyslipidemia. Diabetes was defined as fasting plasma glucose ≥ 126 mg/dl, random plasma glucose ≥ 200 mg/dl, HbA1c ≥ 6.5%, or receiving medical treatment for diabetes mellitus. A logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for hypertension, dyslipidemia, and diabetes.ResultsA total of 117,163 participants (82,487 men and 34,676 women) were analyzed. The prevalence of NWCO was 15.6% in men and 30.2% in women. With reference to NW, the ORs for hypertension (adjusted OR 1.22, 95% CI 1.17–1.27 in men, 1.23, 1.16–1.31 in women), dyslipidemia (1.81, 1.74–1.89 in men, 1.60, 1.52–1.69 in women), and diabetes (1.35, 1.25–1.46 in men, 1.60, 1.35–1.90 in women) were significantly higher in NWCO.ConclusionsNormal weight with central obesity was associated with CVD risk factors, such as hypertension, dyslipidemia, and diabetes, compared with normal weight without central obesity, regardless of sex. It is important to focus on normal weight with central obesity for the prevention of CVD in Japanese middle-aged adults.

GENDER DIFFERENCES IN HEALTH-RELATED BEHAVIORS OF RETIRED PEOPLE IN TAIWAN

Many studies have indicated that lifestyles and health behaviors are important factors associated with elderly health. However, few studies have focused on such issues in Taiwan. The purposes of this study were to examine the gender differences in health-related behaviors of retired people in Taiwan. We used face-to-face interviews to collect 20 health-related behaviors among retired people aged 50-74 in Taiwan. A total of 3131 retired sample was collected including 1754 male (56.0%) and 1377 female (44.0%). The health behaviors were designed as binary variables. If the retirees executed exactly on the behavior within a month, they got 5 scores, otherwise, they got 0 scores. Then, we used factor analysis with Varimax Rotation to detect factors associated with the 20 health behaviors. Results showed that six factors were related to these 20 behaviors after conducting factor analysis. These six factors were named as 1) No tobacco, alcohol and betel nut, 2) Periodic health examination, 3) Correct medication, 4) Good habits, 5) Normal sleep and no pressure, (6) No high-fat and pickled foods. Gender differences were found in three factors: 1, 5 and 6. More female practiced every behavior in factor 1 and factor 6 than male (68.7%, 55.5% vs. 43.6%, 50.3%, p<.001, respectively). However, the male had better behaviors in factor 5 than female (54.0% vs. 47.3%, p<.001). We hope these findings could help design different health promotion programs for retirees of different genders.