Physical Check-up Research Articles

Delivering Anticipatory Guidance About Technology Use to Adolescents in Primary Care: Rates in a Representative California Sample

PurposeThis study aimed to investigate rates of anticipatory guidance about technology use in primary care, as recommended by the American Academy of Pediatrics Bright Futures Guidelines, in a representative sample of California adolescents. MethodsAdolescents 12–17 years of age were interviewed as part of the California Health Interview Survey, the largest state health surveillance survey in the U.S. Participants who reported seeing a doctor for a physical examination or checkup in the prior year were asked if their doctor had talked to them about technology use. ResultsOverall, 29.7% of the 742 participants reported that their doctor talked to them about technology use. There were no statistically significant differences in rates by age, sex, race/ethnicity, household income, or family type. ConclusionsWhile the American Academy of Pediatrics recommends that providers deliver anticipatory guidance about technology use to adolescents in primary care, less than one-third of adolescents surveyed reported having conversations about this topic with their doctor. Given concerns about potential impacts of technology use on adolescent health, medical education should facilitate provider screening and counseling of adolescents about technology use in primary care settings.

The levels of hemoglobin are positively associated with arterial stiffness in community-dwelling Chinese adults

Background and aimsHemoglobin (Hb) concentrations are known to be related to cardiovascular diseases. This study investigated the association between Hb levels and arterial stiffness, as assessed by measurement of the brachial-ankle pulse wave velocity (baPWV). Methods and results3576 adults (2139 males and 1437 females) from the general Chinese population who had their physical check-ups in the health examination centers of Jiangmen Central Hospital were enrolled into the study. The anthropometrics and laboratory data as well as the baPWV and Hb levels were subsequently obtained. Age-adjusted partial correlation and multivariable stepwise linear regression analyses were used to evaluate the relationships between Hb and baPWV for men and women separately. In both sexes, Hb levels were positively associated with body mass index, total cholesterol, low-density lipoprotein cholesterol, triglycerides, glutamic-pyruvic transaminase, γ-glutamyltranspeptidase, uric acid and baPWV, but negatively correlated with the estimated glomerular filtration rate. Multivariable linear regression analysis showed that Hb was significantly and independently associated with arterial stiffness in men (β = 0.043, 95% CI 0.010–0.077, p < 0.05) and women (β = 0.035, 95% CI 0.001–0.069, P < 0.05), after adjustment for confounding factors. ConclusionThe data indicate that high Hb concentration significantly correlate with increased baPWV in general Chinese population.

Sonographic Evaluation of Cholelithiasis and Its Correlation with Normal/Fatty Liver

Cholelithiasis and Fatty Liver disease are usually observed to coexist. Patients who have gallstones also have Fatty Liver as both of the conditions have same associated risk factors I.e., diabetes mellitus, gender, age, obesity, metabolic syndrome, insulin resistance and high lipids level. Non-Alcoholic Fatty Liver Disease (NAFLD) is also an independent accountable risk factor for the formation of gallstones. We aimed to determine whether there is any correlation between cholelithiasis and fatty liver disease. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from March 24,2021 to May 24,2021. Informed consent was taken from all the participants. We did a cohort study comprising the data of 51 patients undergoing physical checkup. The data gathered included age, gender and whether they had normal or fatty liver. Cholelithiasis was diagnosed by confirming the presence of gallstones on abdominal ultrasonography after fasting for approximately 8hrs. it was an observational study for the assessment of correlation between cholelithiasis and fatty liver in the participants. A Total of 51 patients with cholelithiasis were included in our study. Most of the patients were 29 to 70 years of age. The average age of the patients was 42.3 ± 10.1 years. Out of 51 patients, there were 60.8% (P=31) females and 39.2%(P=20) males. Out of 51 cholelithiasis patients there were 31.4%(P=16) had Normal Liver and 68.6%(P=35) were positive with Fatty liver disease. Patients with stone size ranges from 1.90mm to 4.6mm hade Grade 1 Fatty liver as shown in table-5.4, Grade 2 Fatty liver was seen in patients with stone size ranges from 4.5mm to 5.8mm. Fatty liver Grade 3 was not observed in any included patient with cholelithiasis. Results of our study showed that both cholelithiasis and Fatty Liver disease are correlated with each other. Females are at higher risk to be affected by these with diseases. Early detection of Fatty liver in patients of cholelithiasis can help patients to prevent them further complications regarded to fatty liver and cholelithiasis and can play important role in health care of society. Keywords: Non-Alcoholic Fatty Liver Disease, Cholelithiasis, Fatty liver, Ultrasonography. DOI: 10.7176/JHMN/91-07 Publication date: July 31 st 2021

Prediction of prevalence of type 2 diabetes in Rwanda using the metropolis-hasting sampling.

In this work, we predict the prevalence of type 2 diabetes among adult Rwandan people. We used the Metropolis-Hasting method that involved calculating the metropolis ratio. The data are those reported by World Health Organiation in 2015. Considering Suffering from diabetes, Overweight, Obesity, Dead and other subject as states of mathematical model, the transition matrix whose elements are probabilities is generated using Metropolis-Hasting sampling. The numerical results show that the prevalence of type 2 diabetes increases from 2.8% in 2015 to reach 12.65% in 2020 and to 22.59% in 2025. Therefore, this indicates the urgent need of prevention by Rwandan health decision makers who have to play their crucial role in encouraging for example physical activity, regular checkups and sensitization of the masses.

MO532WHICH UNHEALTHY LIFE-BEHAVIOR IS THE MOST IMPACT FOR THE PRESENCE OF PROTEINURIA?

Abstract Background and Aims Unhealthy life-behaviors such as dietary habits, lack of exercise, drinking large amount of alcohol and smoking cause obesity, hypertension, diabetes, dyslipidemia, cardiovascular disease (CVD). These are also closely associated with chronic kidney disease (CKD). CKD is characterized by proteinuria and low glomerular filtration rate (GFR). Independent of GFR, proteinuria is an important predictor of ESKD. Few studies have assessed which is the most clinical impact among the unhealthy life-behaviors: skipping breakfast, snacking, late-night dinner, smoking, heavy alcohol intake and lack of exercise habits for proteinuria in normal renal function patients. Method This cross-sectional study included 29,780 normal renal function patients: eGFR≥60 mL/min/1.73 m2 and no history of kidney diseases who underwent health checkup at the Physical Checkup Center of Sumitomo Hospital. The endpoint of this investigation is defined as dipstick proteinuria of≥ 1+. To assess the association of life-behaviors and the presence of proteinuria, their odds ratios were calculated in adjusted univariable and multivariable logistic regression model. Multivariable logistic regression model was performed by not selected items, the same with univariable model. We would like to investigate the most impact unhealthy life-behavior for the proteinuria. Results Among 29,780 total study subjects (male: 60.3%; mean age: 49±11 years), 1,118 (3.75%) subjects were shown as urinary protein above 1+. The presence of unhealthy dietary life-behaviors: skipping breakfast, snacking and late-night dinner was 5,293 (17.3%), 3,899 (13.1%) and 11,231 (37.7%), respectively. About sleeping duration, the population of &amp;lt;6 hours, 6-8 hours and &amp;gt;8 hours were 12,027 (40.4%), 17,236 (57.9%) and 517 (1.7%). The population of exercise habits: over 3 days/weeks, 1-2 days/weeks and none were 5,138 (17.3%), 9,375 (31.5%) and 15,237 (51.3%), suggesting half of them did not have exercise habits. About smoking habits, the population of current smoking, past smoking and never smoking were shown 6,445 (21.6%), 8,459 (28.4%) and 14,876 (50.0%). In addition, about alcohol amount per day, the population of over 60g, 40-60g, 20-40g and 0-20g were 1,840 (6.18%), 4,504 (15.1%), 6,727 (22.6%) and 16,709 (56.1%). To investigate the impact of life-behavior for proteinuria, we obtained odds ratio of adjusted multivariable logistic regression model. In multivariable regression, among the life-behavior: skipping breakfast, current smoking, alcohol amount (ethanol over 60 g/day), none of exercise habits and snacking were strongly associated with the prevalence of proteinuria (skipping breakfast, adjusted odds ratio 1.45 [1.26, 1.68]; current smoking, 1.35 [1.14, 1.59]; alcohol amount (ethanol over 60 g/day), 1.35 [1.08, 1.69]; none of exercise habits, 1.29 [1.07, 1.57]; snacking, 1.23 [1.04, 1.46]). In addition, among the history of medical history, diabetes mellitus, hypertension and dyslipidemia were significantly associated with the prevalence of proteinuria (diabetes mellitus, adjusted odds ratio 2.39 [1.93, 2.96]; hypertension, 1.83 [1.53, 2.17]; 1.22 [1.03, 1.45]). Conclusion Among the unhealthy life-behaviors, skipping breakfast is the most impact factor for the presence of proteinuria.

Low dietary quercetin intake by food frequency questionnaire analysis is not associated with hypertension occurrence

Quercetin is one of the most abundant flavonoids in plant kingdom. Because of its strong anti-inflammatory and antioxidant effect, it is of potential in anti-hypertension. The objective of the present study was to explore the relationship between dietary quercetin and hypertension incidence in a Chinese population. Participants aged 17-87 years were recruited at baseline. Those people who did not have hypertension, cardiovascular disease or cancer and finished physical checkup were included in this prospective cohort study. A food frequency questionnaire (FFQ) was performed. Follow-up was conducted once a year. The intake of quercetin was calculated based on FFQ and Chinese food composition table. Three Cox proportional hazard regression models were used to investigate the relationship between quercetin intake and incidence of hypertension. The data of 15,662 participants, including 7340 males and 8322 females, were analyzed. The median follow-up period was 3.0 year and the follow-up rate is 85.2%. A total of 2463 subjects developed hypertension during the follow-up period. The mean of daily quercetin intake was 24.7±13.8mg/day in this population. In the multivariate adjusted Cox proportional hazard regression model, the hazard ratios (95% CI) for hypertension across the ascending quartiles of quercetin intake were: 1.00 (reference), 1.04 (0.92, 1.17), 0.99 (0.87, 1.12), and 1.06 (0.92, 1.21). No significant association was observed between quercetin intake and the incidence of hypertension. The dietary intake of quercetin alone does not reach a level sufficient to affect the incidence of hypertension in Chinese population.

ASSOCIATION BETWEEN QUALITY OF SLEEP AND THE DEVELOPMENT OF HYPERTENSION IN NORMOTENSIVE SUBJECTS

Abstract Objective: Although there are many reports on the relationship between sleep time and hypertension, definite conclusions have not been drawn yet. On the other hand, an influence of the feeling of satisfaction about the sleep on the incidence of hypertension remains unknown. We investigated effects of a sleep time and a feeling of satisfaction of sleep on the development of hypertension. Design and method: Normotensive 2162 subjects (male = 1316, 44.7 ± 8.0 year-old at baseline), who visited our hospital for a physical check-up between 2008 and 2015, were enrolled. Quality of sleep (satisfied or not satisfied) and sleep time (&lt;6 hours or &gt; = 6 hours) were assessed by a questionnaire. They were followed up until December 2016 (median 1540 day) with the endpoint being the development of hypertension. Hypertension was defined as blood pressure &gt; = 140/90mmHg or the use of antihypertensive medications. Results: During the follow-up, hypertension developed in 846 subjects (42.0 per 1000 person-year), with the incidence being more frequent in male than female subjects (52.3 vs. 24.9 per 1000 person-year). The incident hypertension was higher in subjects who were satisfied with their sleep than those who were not (48.3 vs. 32.5 per 1000 person-year). Multivariate Cox-hazard analysis adjusted for possible risk factors revealed that feeling of satisfaction (hazard ratio [HR]:1.395, 95% confidence interval [CI]:1.120–1.738), but not the duration of sleep, was associated with the development of hypertension. Among subjects who feel their sleep time sufficient, HR (95%CI) was 1.921 (1.225–3.011) in subjects with a sleep time &gt; = 6 hours and 1.387 (1.087–1.770) in those with a sleep time &lt; 6 hours. Conclusions: A feeling of satisfaction of sleep rather than a sleep time may be an important factor that leads to the development of hypertension though the results should be interpreted with a caution because data on sleeping status were obtained from questionnaire. Further investigation is necessary to clarify the mechanism underlying the association between the development of hypertension and satisfaction of sleep.

EFFECTS OF SMOKING ON CENTRAL BLOOD PRESSURE

Abstract Objective: Smoking is known to induce systemic vascular damage, leading to cardiovascular diseases. Recent studies demonstrated that central blood pressure has a greater impact on cardiovascular events than brachial blood pressure. We investigated effects of habitual smoking on central systolic blood pressure (CSBP) in the general population. Design and method: A total of 5630 subjects (male = 2622, 51.7 ± 12.0 year-old at baseline), who visited our hospital for a physical check-up at least twice during the last 10 years and underwent CSBP measurement at each visit, were enrolled, and effects of smoking on the average and yearly changes of CSBP (median follow-up 5 years) were analyzed. Brachial blood pressure (oscillometer) and radial artery pressure waveforms (tonometer) were recorded using an automated device, and the pressure corresponding to the second systolic peak of radial pressure waveforms was taken as CSBP (HEM-9000AI, Omron Healthcare, Kyoto). Hypertension was defined as brachial BP &gt; = 140/90mmHg or the use of antihypertensive medications. A yearly change in CSBP was calculated in each subject by linear regression analysis using longitudinal data. Results: The average CSBP during the follow-up was higher in habitual smokers than in non-smokers when analyzed in normotensive (n = 4634, 109.1 ± 11.7 vs. 107.6 ± 12.8 mmHg, p &lt; 0.001) and non-treated hypertensive subjects (n = 91, 150.7 ± 14.8 vs. 142.8 ± 16.7 mmHg, p &lt; 0.05), whereas in hypertensive subjects under medication the average CSBP was lower in smokers than in non-smokers (n = 905, 124.6 ± 12.4 vs. 127.8 ± 13.6 mmHg, p &lt; 0.01). Although smoking status did not affect yearly changes of CSBP in both normotensive (habitual smokers vs. non-smokers; 1.38 ± 6.00 vs. 1.44 ± 6.04 mmHg/year) and treated hypertensive subjects (-0.16 ± 7.08 vs. -0.66 ± 8.24 mmHg/year), the unfavorable effect of smoking on yearly increase of CSBP was found in non-treated hypertensive subjects (4.09 ± 15.1 vs. -0.53 ± 10.3 mmHg/year). Conclusions: Habitual smoking increases CSBP especially in subjects with hypertension, however, antihypertensive medications counteract the unfavorable effects of smoking on CSBP. These results imply a new pathway underlying the development of cardiovascular diseases in smokers. Unfavorable changes in the cardiovascular system caused by smoking may quite slowly progress that short period of observation in the present study could not have detected enhanced yearly increases of CSBP by smoking.

STUDI KASUS : FIBROSARCOMA PADA ANJING POMERANIAN MIX

Fibrosarcoma is a malignant neoplasm of fibroblast that commonly found in middle-aged or older dogs. Breed and sex do not influence the incidence of fibrosarcoma. A 10 years old grey female mix Pomeranian with a bodyweight of 9.2 kg showed a semi-solid mass, with meat-like consistency that felt integrated with the tissue underneath. A mass with a diameter of ± 5 cm had been found in the left thigh near the anus. The other two unusual masses with smaller size (diameter ±1 cm) were also found at lateral sinister near extremities cranial of the body. A serial of diagnostic check-ups, such as physical and clinical check-up, USG, haematology, cytology, and histopathology tests was run to examine the dog condition. The USG result showed hypoechoic masses with slightly anechoic appearances. The haematology analysis showed a decrease in lymphocyte, MCV and hematocrit, meanwhile the granulocyte, MCHC and MHC showed an increasing trend. The cytology test revealed a fat-like vacuolization. Furthermore, the histology examination indicating the presence of large hyperchromic oval cells. The histopathology examination also found fibroblast cells that suspected as tumour cells with mitotic and infiltrated oval cores. Thus, the dog was diagnosed with fibrosarcoma and the prognosis was dubious. The surgery was done to remove the tumour masses.

Growth and neurodevelopment in low birth weight versus normal birth weight infants from birth to 24\u2009months, born in an obstetric emergency hospital in Haiti, a prospective cohort study

BackgroundLow birthweight (LBW) infants are at higher risk of mortality and morbidity (growth, chronic disease and neurological problems) during their life. Due to the high incidence of (pre-) eclampsia in Haiti, LBW infants are common. We assessed the anthropometric growth (weight and length) and neurodevelopmental delay in LBW and normal birthweight (NBW) infants born at an obstetric emergency hospital in Port au Prince, Haiti, between 2014 and 2017.MethodsInfants were followed at discharge and 3, 6, 12, 15, 18, 21 and 24 months of corrected gestational age. At each visit they underwent a physical checkup (weight, length, physical abnormalities, identification of morbidities). At 6, 12, 18 and 24 months they underwent a neurodevelopmental assessment using the Bayley Scale III (motor, cognitive and communication skills). We modelled the trajectories between birth and 24 months of age of NBW compared to LBW infants for weight, length, and raw scores for Bayley III assessments using mixed linear models.ResultsIn total 500 LBW and 210 NBW infants were recruited of which 333 (46.7%) were followed up for 24 months (127 NBW; 60.5% and 206 LBW; 41.2%) and 150 died (LBW = 137 and NBW = 13). LBW and NBW babies gained a mean 15.8 g and 11.4 g per kg of weight from discharge per day respectively. The speed of weight gain decreased rapidly after 3 months in both groups. Both groups grow rapidly up to 6 months of age. LBW grew more than the NBW group during this period (22.8 cm vs. 21.1 cm). Both groups had WHZ scores <− 2 up to 15 months. At 24 months NBW babies scored significantly higher on the Bayley scales for gross motor, cognitive and receptive and expressive communication skills. There was no difference between the groups for fine motor skills.ConclusionLBW babies that survive neonatal care in urban Haiti and live up to 24 months of age, perform similar to their NBW for weight, length and fine motor skills. LBW babies are delayed in gross motor, cognitive and communication skills development. Further research on the clinical significance of these findings and long term implications of this neurodevelopmental delay is needed.

Physical Functioning Among Community-Dwelling Elderly in Rural Indonesia.

As people live longer and the number of elderly individuals increases, caring for the elderly and increasing quality of life become important health care concerns. The aim of this study is to assess physical functioning among elderly people in rural Indonesia and draw conclusions about factors that might impact physical functioning. This study involved 412 elderly individuals aged 60 and over selected by multistage random sampling. A logistic regression was used to determine factors which associated with physical functioning. Older age (75+), suffered from chronic illness, and living in low- and middle- income households tend to have limitations on physical function. Also, elderly individuals who had partner and were currently working experienced better physical function than those who did not. This study supports other findings that say elderly people should do activities that reduce the risk of developing chronic illnesses. Having regular physical activity and routine preventive health check-ups can improve overall health, protect from having diseases and maintain the physical function of the elderly.

Does health literacy affect the uptake of annual physical check-ups?: Results from the 2017 US health information national trends survey

BackgroundLittle is known about how health literacy is linked to physical check-ups. This study aimed to examine the levels of physical check-ups (self-reported check-ups within the last year) by age group (those aged 18–59 years and those aged = ≥ 60 years) and the role of health literacy regarding physical check-ups in the United States.MethodsData for the study were obtained from the 2017 Health Information National Trends Survey. The original sample included 3,285 respondents, but only 3,146 surveys were used for this study. Andersen’s Behavioral Model of Health Services Use guided this study, and a binomial logistic regression model was conducted using Stata 12.0 software package.ResultsWhile 82.0 % of the older group had an annual check-up, 67.3 % of the younger group had one. Both groups had similar ratios for health literacy-related item reporting. Study results show that annual check-up was positively associated with confidence in getting health information, having health insurance, and having a primary doctor for both age groups. However, getting a regular check-up was negatively associated with frustration while searching for information among the younger group. In comparison, it was positively associated with difficulty understanding information for the older group.ConclusionsTo increase annual physical check-ups, health literacy-related interventions should be developed and address the barriers most associated with health check-ups. One way of addressing this barrier is to improve communication from healthcare professionals to consumers through the use of easy-to-understand explanations appropriate for the consumer.

The Relationship between Physical Activity, Dietary Patterns, Sex, Age, and BMI of Employees of Dispora NTT

Working as an employee at the Department of Youth and Sports (Dispora), NTT province is likely to increase the risk of sedentary activities. A sedentary lifestyle can contribute to obesity. This study analyzed the relationship between physical activity, dietary patterns, sex, age, and the body mass index (BMI) of the Dispora employees in Indonesia's East Nusa Tenggara Province. The study used a cross-sectional study design. The chosen sample consisted of 60 Department of Youth and Sports employees, selected using a simple random sampling technique. This research directly assessed each participant's BMI, while all other data collated from questionnaires, including IPAQ, food recall (2 x 24 hours), and FFQ. In total, 51.6% of employees reported less physical activities, high dietary intake (45.0%), good consumption of foods (45.0%), high variety of foods (51.7%), were not at high risk of age (51.7%), and obese (55.0%). The results of the statistical analysis tests using chi-square and fisher's exact tests concluded that physical activity (p-value = 0.000) and energy intake (p-value = 0.000) had significant effects on BMI, while frequency of eating (p-value = 0.174), the variety of food consumed (p-value = 0.104), sex (p-value = 0.299), and age (p-value = 0.775) had no effect on BMI. Employees should maintain a normal BMI, sufficient physical activity, balanced nutrition, and regular check-ups.

Health Care Access Among Essential Critical Infrastructure Workers, 31 States, 2017-2018.

Essential workers in the United States need access to health care services for preventive care and for diagnosis and treatment of illnesses (coronavirus disease 2019 [COVID-19] or other infectious or chronic diseases) to remain healthy and continue working during a pandemic. This study evaluated access to health care services among selected essential workers. We used the most recent data from the Behavioral Risk Factor Surveillance System, 2017-2018, to estimate the prevalence of 4 measures of health care access (having health insurance, being able to afford to see a doctor when needed, having a personal health care provider, and having a routine checkup in the past year) by broad and detailed occupation group among 189 208 adults aged 18-64. Of all occupations studied, workers in farming, fishing, and forestry occupations were most likely to have no health insurance (46.4%). Personal care aides were most likely to have been unable to see a doctor when needed because of cost (29.3%). Construction laborers were most likely to lack a personal health care provider (51.1%) and to have not had a routine physical checkup in the past year (50.6%). Compared with workers in general, workers in 3 broad occupation groups-food preparation and serving; building and grounds cleaning and maintenance; and construction trades-had significantly lower levels of health care access for all 4 measures. Lack of health insurance and underinsurance were common among subsets of essential workers. Limited access to health care might decrease essential workers' access to medical testing and needed care and hinder their ability to address underlying conditions, thereby increasing their risk of severe outcomes from some infectious diseases, such as COVID-19. Improving access to health care for all workers, including essential workers, is critical to ensure workers' health and workforce stability.

High Expression of Tumor Abnormal Protein Preoperatively Predicts Poor Prognosis of Patients With Esophageal Squamous Cell Carcinoma.

Background: Esophageal squamous cell carcinoma (ESCC) acts as a fatal malignant tumor among human beings and is marked by late-stage diagnosis, frequent recurrence, metastasis, and therapy resistance. Tumor abnormal protein (TAP) remarkably affects cancer development and progression of human cancers. TAP has been shown to be a biomarker for gastric and lung cancer progression. Nevertheless, the clinical value exhibited by TAP for ESCC has not been well-explained in the current literature.Methods: The present study included 183 ESCC cases who received surgical resection and 183 cases who had normal physical checkup from March 2013 to January 2015 at the People's Hospital of Chizhou, and used the TAP detection agent for evaluating the TAP relative level.Results: As found, ESCC patients presented an obviously higher TAP expression relative to cases who had normal physical checkup. Moreover, TAP expression was significantly downregulated after surgery. Furthermore, the TAP expression was correlated with gender, smoking, pathologic differentiation, and pN stage, but not with age, tumor location, surgical type, pT stage, and vascular invasion. High expression of TAP was significantly correlated with poorer overall survival (OS) rate in ESCC patients. TAP was an independent prognostic predictor in ESCC patients, based on the multivariate survival analysis.Conclusion: The study reveals how TAP upregulation promotes ESCC malignant progression, and concludes that TAP acts as the therapeutic target and potential biomarker specific to ESCC.

Clinical characteristics of COVID-19 complicated with pleural effusion

BackgroundEpidemiological and clinical features of patients with corona virus disease 2019 (COVID-19) were well delineated. However, no researches described the patients complicated with pleural effusion (PE). In the present study, we aimed to clinically characterize the COVID-19 patients complicated with PE and to create a predictive model on the basis of PE and other clinical features to identify COVID-19 patients who may progress to critical condition.MethodsThis retrospective study examined 476 COVID-19 inpatients, involving 153 patients with PE and 323 without PE. The data on patients’ past history, clinical features, physical checkup findings, laboratory results and chest computed tomography (CT) findings were collected and analyzed. LASSO regression analysis was employed to identify risk factors associated with the severity of COVID-19.ResultsLaboratory findings showed that patients with PE had higher levels of white blood cells, neutrophils, lactic dehydrogenase, C-reactive protein and D-dimer, and lower levels of lymphocytes, platelets, hemoglobin, partial pressure of oxygen and oxygen saturation. Meanwhile, patients with PE had higher incidence of severe or critical illness and mortality rate, and longer hospital stay time compared to their counterparts without pleural effusion. Moreover, LASSO regression analysis exhibited that pleural effusion, lactic dehydrogenase (LDH), D-dimer and total bilirubin (TBIL) might be risk factors for critical COVID-19.ConclusionsPleural effusion could serve as an indicator for severe inflammation and poor clinical outcomes, and might be a complementary risk factor for critical type of COVID-19.

The Serum Concentrations of Hedgehog-Interacting Protein, a Novel Biomarker, Were Decreased in Overweight or Obese Subjects.

Although it was known that obesity is an independent risk factor for metabolic disorders including diabetes, the factors that link these diseases were obscure. The Hedgehog-interacting protein (Hhip) is a negative regulator in tissue remodeling, and inhibits the proliferation of adipocytes, and promotes their differentiation. In addition, Hhip was positively associated with diabetes. However, the relationship between Hhip and obesity in the human body remains unclear. An analysis of the relationship between Hhip and normal weight, overweight, and obesity levels. Participants receiving a physical checkup were recruited. Anthropometric and biochemical data were collected. Serum Hhip levels were determined by enzyme-linked immunosorbent assay (ELISA). Subjects were classified into normal-weight, overweight, and obese groups based on their body mass index (BMI). The association between Hhip and obesity was examined by multivariate linear regression analysis. In total, 294 subjects who were either of a normal weight (n = 166), overweight (n = 90), or obese (n = 38) were enrolled. Hhip concentrations were 6.51 ± 4.86 ng/mL, 5.79 ± 4.33 ng/mL, and 3.97 ± 3.4 ng/mL in normal-weight, overweight, and obese groups, respectively (p for trend = 0.032). Moreover, the regression analysis showed that BMI (β = −0.144, 95% confidence interval (CI) = −0.397−0.046, p = 0.013) was negatively associated with Hhip concentrations after adjusting for sex and age. Being overweight (β = −0.181, 95% CI = −3.311−0.400, p = 0.013) and obese (β = −0.311, 95% CI = −6.393−2.384, p < 0.001) were independently associated with Hhip concentrations after adjusting for sex, age, fasting plasma glucose, the insulin level, and other cardiometabolic risk factors. Our results showed that overweight and obese subjects had lower Hhip concentrations than those of normal weight. Being overweight and obese were negatively associated with Hhip concentrations. Hhip might be a link between obesity and diabetes.

Blood Cholesterol Levels of Family Members of Stroke Patients in Suburban Areas

Objective: (1) To study dyslipidemia prevalence of members in stroke patients’ families (2) To investigate factors related to dyslipidemia of members in stroke patients’ familiesMaterial and Methods: In this cross-sectional analytical study, after patients suffered from a stroke, the subjects were visited, interviewed through a questionnaire, and blood was drawn for testing, without fasting. This was in order to establish their cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and random plasma glucose. This also included a physical checkup and risk assessment for cardiovascular disease. The data were collected from 120 subjects.Results: Prevalence of high total cholesterol level was 34.2%, low HDL-C was 15.8%, high LDL-C level was 37.5%, and prevalence of dyslipidemia was 51.7%. The samples were 76 blood relatives and 44 non-blood relatives in the patients’ families. The average LDL-C level was 147.12+39.06 and 31.7% of them suffered from Class 1 obesity, and 15.8% of them faced Class 2 obesity. According to Thai CV risk scores, the results revealed that 80.8% of the samples had a low risk, at &lt;10.0%. The factors related to dyslipidemia were underlying diseases, and most groups of underlying diseases were hypertension and diabetes mellitus, respectively.Conclusion: Prevalence of dyslipidemia in family Members of Stroke Patients was 51.7%. Detection of this abnormality is important to them. This would help in designing a prevention plan, as well as to raise awareness of stroke prevention in family members of stroke patients.

Burnout and metabolic syndrome among healthcare workers: Is subclinical hypothyroidism a mediator?

ObjectivesEvidence suggests that subclinical hypothyroidism (SCH) is associated with burnout and metabolic syndrome (MetS). We examined the relationship between burnout and MetS among healthcare workers (HCWs) and investigated the potential mediation of SCH.MethodsThis cross‐sectional study included HCWs from a tertiary medical center; demographic data were obtained using a questionnaire. Burnout was evaluated according to the Chinese version of the Maslach Burnout Inventory–Health Services Survey (MBI–HSS). MetS and thyroid function data were obtained from a physical check‐up. Logistic regression models were used to evaluate the adjusted odds ratio (aOR), and mediation analysis was employed to examine the mediation effect.ResultsAmong 945 non‐doctor/nurse and 1868 doctor/nurse staff, MetS was 30% and 14%, respectively, and the prevalence of burnout was nearly 6.5%. The results showed that burnout induced higher aOR of MetS in the doctor/nurse group (1.27, 95% confidence interval [CI]: 1.05‐3.62). Thyroid‐stimulating hormone (TSH) showed a positive association factor of MetS in doctor/nurse group‐adjusted burnout (aOR = 1.15, 95% CI: 1.01‐4.19). A higher TSH level was associated with an increased odds of MetS in younger doctor/nurse staff with burnout syndrome (aOR = 1.74; 95% CI: 1.04‐3.22). There was a borderline significant mediation effect of SCH in the association between burnout and MetS in doctor/nurse staff.ConclusionsThe results showed that higher TSH levels were positively associated with burnout and MetS in doctor/nurse professionals, especially in the young cohort. Burnout may rely on the borderline mediation effect of SCH, which is likely to affect MetS.

Current status and recent changes in blood pressure and dietary salt consumption in Japanese individuals

ABSTRACT Purpose: Treatment of hypertension has recently shown remarkable advances. It is quite important to survey the current general status of blood pressure (BP) and recent changes to verify whether people are benefitting from these advances. The present study aimed to investigate the current status of, and recent changes in, BP, the prevalence and treatment rate of hypertension, the achievement rate of target BP, and salt intake in Japanese individuals. Methods: Recent changes in salt intake as well as BP, the prevalence and treatment rate of hypertension, and the rate of achievement of target BP were investigated in participants in our yearly physical checkup program from 2009 to 2018 (n = 79,789). Individual salt intake was assessed by estimating 24-hour urinary sodium excretion using a spot urine sample. Results: The prevalence of hypertension did not change, but the treatment rate of hypertension (from 64% to 75%) and the achievement rate of the target BP improved during the period (from 35% to 57%). BP decreased, prominently in hypertensive participants under antihypertensive treatment (from 133 ± 14/84 ± 9 to 128 ± 13/76 ± 10 mmHg). Salt intake did not decline noticeably during the 10 years of observation. Conclusions: The prevalence of hypertension did not change, but the treatment rate of hypertension and the achievement rate of the target BP improved during a recent 10-year period. These findings suggest that improved pharmacological management of hypertension resulted in a gradual reduction in BP levels, but lifestyle modification has not yet really taken root in the Japanese general population.