Times Higher Prevalence Research Articles

Life is precious: A quasi-experimental study of a community-based program to prevent suicide among Latina adolescents in New York City.

Rising rates of suicidal thoughts and behaviors (STBs) among U.S. Latina adolescents urgently need attention. Life is Precious (LIP) is a culturally responsive, community-based, afterschool-model program offering wellness-support services to supplement outpatient mental health treatment for Latina adolescents experiencing STB's. This 12-month quasi-experimental pilot study explored LIP's impact on clinical outcomes. Latina adolescents newly enrolled in LIP and receiving outpatient treatment (n = 31) and those newly starting outpatient treatment only (n = 12; Usual Care) were assessed for Suicidal Ideation (Suicidal Ideation Questionnaire; SIQ) and depressive symptoms (Patient Health Questionnaire-9). We estimated differences in mean scores using longitudinal linear mixed models and adjusted risk ratios (ARRs) of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements using exact logistic models. The direction of the estimated impact of LIP was positive [differences (95% CIs): -15.5 (-34.16, 3.15) for SIQ; -1.16 (-4.39, 2.07) for PHQ-9], with small-to-moderate nonsignificant effect sizes (0.19-0.34). LIP participants saw two to three times higher prevalence than controls of SIQ-25%, SIQ-50%, and PHQ-9-5-point improvements; ARRs (95% CIs) were 1.91 (0.61, 3.45), 3.04 (0.43, 11.33), and 1.97 (0.44, 5.07), respectively. Suicidal behaviors also decreased in LIP. The effects of LIP were in positive directions across clinical outcomes, warranting further research on its effectiveness in decreasing STBs.

Prevalence of at-risk NASH and its association with metabolic syndrome in US adults with NAFLD, 2017-2018.

Patients with metabolic syndrome (MetS) have a higher risk for NASH and significant fibrosis. Presence of NASH and advanced fibrosis are associated with adverse outcomes in patients with NAFLD. Using a noninvasive method, we determined the prevalence of at-risk NASH and its association with MetS components in a large population-based analysis. We used the 2017-2018 National Health and Nutrition Examination Survey and included adults ≥18 years with NAFLD (controlled attenuation parameter ≥274dB/m). Pregnancy, subjects with other causes of liver disease or missing data were excluded. FibroScan-AST (FAST) score was calculated using aspartate aminotransferase, liver stiffness measurement, and controlled attenuation parameter. Patients with a FAST score >0.35 were considered to have at-risk NASH, defined as NASH with NAFLD activity score ≥4 and fibrosis stage ≥2 on liver biopsy. The sample included 687 patients. The overall prevalence of at-risk NASH was 11.6% (95% CI: 8.8-15.1) and was higher in males than females (15.8% vs. 6.5%; p < 0.001). Subjects with comorbidities (diabetes mellitus, obesity, MetS, and insulin resistance) had between 1.3 and 1.7 times higher prevalence than the general population. Among MetS components, elevated glucose/diabetes, large waist circumference, and low HDL were independent risk factors for at risk-NASH. The number of MetS components was also important-one additional component increased the odds of at-risk NASH by 2 times. The FAST score had the highest correlation with alanine aminotransferase (r= 0.70; p < 0.001). We estimated ~9 million people in the US have at-risk NASH and may benefit from active surveillance and therapy.

Informal Employment and Poor Mental Health in a Sample of 180,260 Workers from 13 Iberoamerican Countries.

The aim of this study is to estimate the association between employment conditions and mental health status in the working population of Iberoamerica. In this cross-sectional study, we pooled individual-level data from nationally representative surveys across 13 countries. A sample of 180,260 workers was analyzed. Informality was assessed by social security, health affiliation, or contract holding. Mental health was assessed using several instruments. We used Poisson regression models to estimate the contribution of informality to poor mental health by sex and country, adjusted by sociodemographic and work-related characteristics. Then, we performed a meta-analysis pooling of aggregate data using a random-effects inverse-variance model. Workers in informal employments showed a higher adjusted prevalence ratio (aPR) of poor mental health than those in formal employment in Peru (aPR men 1.5 [95% confidence intervals 1.16; 1.93]), Spain (aPR men 2.2 [1.01; 4.78]) and Mexico (aPR men 1.24 [1.04; 1.47]; women 1.39 [1.18; 1.64]). Overall estimates showed that workers in informal employment have a higher prevalence of poor mental health than formal workers, with it being 1.19 times higher (aPR 1.19 [1.02; 1.39]) among men, and 1.11 times higher prevalence among women (aPR 1.11 [1.00; 1.23]). Addressing informal employment could contribute to improving workers’ mental health.

Association between sociodemographic characteristics and adherence to early detection of breast cancer

Objective: to verify the association between sociodemographic characteristics and the performance of actions for early detection of breast cancer. Methods: a cross-sectional study was carried out in six primary health care units, with 400 women considered a target population for actions for early detection of breast cancer. The Chi-square test of independence (2x2) was used for inferential analysis. Results: most women were between 60 and 64 years old, married, had low education and lacked an occupation or health insurance. A significant association was found between marital status and the interval between requesting and performing a mammogram (X2(1) = 208.185, p&lt;0.001, Phi-coefficient= 0.902; Confidence Interval: 0.0308–0.0928). Women without a partner had a 0.95 times higher prevalence of having a mammogram. Conclusion: there was an association between the sociodemographic variable marital status and the performance of mammography in a shorter period, and not having a partner was a protective factor. Contributions to practice: the elucidation of factors related to the performance of actions for breast cancer screening can signal patients who need greater vigilance regarding the presence of signs and symptoms suggestive of breast cancer.

Crossed renal ectopy. Presentation of a clinical case at the Hospital Regional Tlalnepantla ISSEMYM, Estado de México

Abstract Crossed renal ectopia is a rare congenital abnormality, where the ectopic kidney crosses the midline, and is located in a position contralateral to its normal position 1. It has a higher prevalence in men in relation to 2-3: 1to women 2, and it has a 3 times higher prevalence on the right side than on the left. Most of the cases are asymptomatic and the diagnosis is made when a pathology is established on the ectopic kidney, such as infections, lithiasis, tumors or other less frequent ones3. A case presentation of a 57-year-old male patient is made, in which the presence of the anatomical anomaly was incidentally discovered. Objective: To present a clinical case report of a patient with a condition of Cross Renal Ectopia as an image study finding. Material and methods: Descriptive study where complementary imaging studies are made, in relation to current condition. Results: A patient with a condition of Cross Renal Ectopia was shown at the Tlalnepantla Regional Hospital ISSEMYM, presenting an incidence of less than 0.2% in frequency within the Mexican population. frequency within the Mexican population. Keywords. Renal ectopia, abnormality, congenital, kidney, ureter, tomography, abdomen.

Sex and age differences in migraine treatment and management strategies.

Migraine is one of the leading causes of disability worldwide, especially in women younger than 50 years old. Migraine has three times higher prevalence in women than in men and tends to decrease after the menopausal transition. Migraine has different clinical features in people of different ages. Clinical symptoms and factors associated with migraine can be various in women and men. Women have special types of migraine, such as pure menstrual migraine and menstrually related migraine. Besides, clinical symptoms of migraine can change during pregnancy, postpartum and lactation. Women are significantly more often than men consulting a doctor because of migraine. These features of migraine lead to different treatment and management strategies in females and males of different ages. Migraine therefore is a disorder that demonstrates the necessity of a personalization of healthcare-ensuring the proper treatment for the right patient, at the right time. Considering all the available literature and guidelines, in this chapter several strategies for management of acute and prophylactic treatments of migraine, according to sex and age differences, are discussed. The purpose of this chapter is to provide a useful piece of information improving the treatment and management of migraine.

Clinical features of chronic obstructive pulmonary disease in the elderly

Analysis of randomized, retrospective and prospective clinical, case-control, and observational studies revealed the following main features of COPD in the elderly: (1) COPD is a complex and common condition in elderly patients, characterized by high rates of disturbing symptoms, significant risk of cognitive and functional decline, disease progression, frequent use of health care, extremely difficult treatment and increased mortality. (2) The elderly have an increased prevalence of COPD: in subjects aged 65 years and over, it represents 14,2% (from 11,0% to 18,0%), compared to 9,9% (from 8.2% to 11.8%) in those aged 40 and over. (3) Simultaneously with the 2-4 times higher prevalence of COPD, the elderly patients, especially those aged 75 years or older, also have a higher burden of the disease: frequency, severity and impact of symptoms significantly higher. higher, tolerance to effort and lower daily activities, higher incidence of severe acute exacerbations and higher prevalence of systemic comorbidities. (4) COPD acute exacerbations and comorbidities have poorer results in elderly patients, fact manifested by an increased rate and duration of the hospitalization, an increased rate of repeted hospitalizations and a higher mortality rate. (5) COPD is a multifaceted condition that involves more than just obstruction of the airflow. Systemic inflammation contributes to the development of systemic effects (loss and dysfunction of skeletal muscle, osteoporosis, anemia, cachexia, neurocognitive dysfunction). (6) Multidimensional assessment and multidisciplinary intervention, well recognized in the geriatric population, should be extended to patients with COPD

906. Characteristics of Chronic Hepatitis B Patients with Severe Outcomes in a Large Integrated Healthcare System - 2008-2019

BackgroundIt is estimated that there are 1.59 million cases of chronic hepatitis B virus (HBV) infection (CHB) in the United States. HBV infection is highest among men and non-Hispanic Asian adults. CHB can lead to liver damage, cirrhosis, hepatocellular carcinoma, or death. However, the population that is most likely to develop severe outcomes is not as well-defined.MethodsWe evaluated electronic health record data from Kaiser Permanente Southern California adult members from 2008-2019 with at least 1 year of continuous membership, and with 2 successive, positive HBV lab results (HBV DNA, or HBsAg, or HBeAg) at least 6 months apart (indicative of CHB). Severe outcomes included incident hepatic decompensation, hepatocellular carcinoma (HCC), liver transplant and death, and prevalent and incident liver cirrhosis. For each outcome, we estimated the distribution of characteristics including age, sex, race/ethnicity, and lab values (alanine aminotransferase [ALT], alpha-fetoprotein [AFP], MELD score).ResultsOur final study population included 5,427 CHB-diagnosed patients with 411 (7.6%) cases of liver cirrhosis, 123 (2.3%) of hepatic decompensation, 65 (1.2%) of HCC, 8 (0.1%) of liver transplant, and 164 (3.0%) deaths. Compared to the total cohort, those who developed severe outcomes were older (median age for each outcome >50 years vs. 47 years in total CHB population). Among those with severe outcomes, the majority were male ( >56%) and Asian. Diabetes was more prevalent in patients with hepatic decompensation, HCC, and death versus the entire cohort (25% vs. 8%, respectively, P< 0.0001), and twice as prevalent among those with cirrhosis. All severe outcomes were associated with >2 x upper limit of normal ALT levels. ConclusionThe characteristics of those with severe outcomes were consistent with those of overall CHB, although there was a 2-3 times higher prevalence of diabetes in those with severe outcomes. Identifying characteristics that are more prevalent in those with severe outcomes can help inform screening and management of CHB.Disclosures Ana Florea, PhD MPH, Gilead Inc. (Grant/Research Support) Prabhu Gounder, MD, Gilead Inc. (Grant/Research Support) Amandeep Sahota, MD, MS, Gilead Inc (Grant/Research Support) Katherine J. Pak, MS, Gilead (Grant/Research Support) Vennis Hong, MPH, Gilead Inc. (Research Grant or Support) Theresa M. Im, MPH, Gilead Inc. (Grant/Research Support) Sara Tartof, PhD, Gilead (Grant/Research Support, Scientific Research Study Investigator)

Prevalence of antibodies against SARS-CoV-2 according to socioeconomic and ethnic status in a nationwide Brazilian surveyPrevalência de anticorpos contra o SARS-CoV-2 de acordo com o status socioeconômico e étnico em uma pesquisa nacional no Brasil

RESUMENObjetivos.Investigar las desigualdades socioeconómicas y entre distintos grupos étnicos en la prevalencia de anticuerpos contra el SARS-CoV-2 en las 27 unidades federativas de Brasil.Métodos.En este estudio transversal, se realizaron tres encuestas de hogares los días 14-21 de mayo, 4-7 de junio y 21-24 de junio de 2020 en 133 áreas urbanas brasileñas. Se utilizó un muestreo de etapas múltiples para seleccionar 250 individuos en cada ciudad a fin de someterlos a una prueba rápida de anticuerpos. Los sujetos respondieron un cuestionario sobre los bienes del hogar, la escolaridad y el color de la piel y etnia (autodeclarado utilizando la clasificación brasileña estándar de cinco categorías: blanco, negro, pardo, asiático o indígena). Se utilizó el análisis de los componentes principales de los bienes para clasificar el estatus socioeconómico en cinco quintiles de riqueza. Se empleó la regresión de Poisson para los análisis.Resultados.Se analizaron 25 025 sujetos en la primera encuesta, 31 165 en la segunda y 33 207 en la tercera, que mostraron una prevalencia de resultados positivos de 1,4%, 2,4% y 2,9%; respectivamente. Los individuos del quintil más pobre tuvieron 2,16 veces más probabilidades de presentar un resultado positivo (intervalo de confianza del 95%: 1,86-2,51) que los del quintil más rico, y los que tenían 12 o más años de escolaridad tuvieron una prevalencia menor que los sujetos con menos educación. Las personas indígenas presentaron una prevalencia 4,71 (IC95%: 3,65-6,08) veces mayor que las blancas, al igual que las de piel negra o parda. El ajuste por región del país redujo los índices de prevalencia según la riqueza, la educación y el origen étnico, pero los resultados siguieron siendo estadísticamente significativos.Conclusiones.La prevalencia de anticuerpos contra el SARS-CoV-2 en Brasil muestra gradientes relacionados con la posición socioeconómica y la etnia muy pronunciados, con menor riesgo en las personas blancas, educadas y ricas.

Prevalence, indications and demographic characteristics of Botulinum neurotoxin use in a tertiary oculoplastic centre.

Over the past 40 years, Botulinum Neurotoxin (BoNT) treatment has been used in many presentations to the hospital eye service. There is little published on its practice in an ophthalmology setting. We aim to report on the prevalence of BoNT use, indications for treatment, age, gender, socioeconomic and ethnic variations observed, and dosages used. We performed a retrospective cross sectional observation study on the use of botulinum neurotoxin treatment in the oculoplastic department of a busy tertiary centre in the University Hospitals of Leicester, United Kingdom. The prevalence of BoNT in the service was 13.7 per 100,000 people. Of the 145 cases identified, the commonest indications for treatment were hemifacial spasm (62% of cases) and blepharospasm (29% of cases). Proportionally, twice as many females than males received BoNT (χ2 = 17.3, p < 0.0001). For those >30 years of age, the prevalence increased with age with those >90 years having a seven times higher prevalence than the mean. Overall, no significant differences were found in ethnicity and median index of multiple deprivation rank between those with treatment and the general population although specific district council variations were noted. These findings would assist commissioners in providing adequate resources to meet demand based on the demographics of their local population. Further qualitative and quantitative research is required to enhance our understanding of some of these trends.

Low Level of Serum Cadmium in Relation to Blood Pressures Among Japanese General Population.

Hypertension (HT) is an important risk factor for mortality and morbidity. Previous studies showed that cadmium (Cd) was associated with increased blood pressures and the prevalence of HT. This study hypothesized that Cd, regardless of its level, may increase blood pressures/HT. The objective of this study was to examine the associations between alow level of serum Cd concentration and blood pressures/HT among a general population in the Iwaki area, Japan. This was a cross-sectional study, conducted in the Aomori prefecture with 1144 volunteers aged over 19 years old, who were participants of the Iwaki health check-up in 2014. The study assessed questionnaire survey, body composition, and serum Cd concentrations. Median serum Cd concentration was 0.06 ng/mL (interquartile range 0.05-0.08 ng/mL) among our study population. Compared to the lowest quintile of serum Cd concentration group, the highest quintile of serum Cd concentration group had 4.9 mmHg higher systolic blood pressure (SBP) (95% confidence interval [CI] 1.53-8.31, p < 0.01) and 2.4 mmHg higher diastolic blood pressure (DBP) (95% CI 0.36-4.34, p < 0.05), compared to the lowest quintile group. Similarly, the highest quintile of serum Cd concentration group had 1.7 times higher prevalence of HT (95% CI 1.10-2.51, p < 0.05) than the lowest quintile group. This study identified that higher serum Cd concentration was significantly, positively, associated with SBP and DBP and HT prevalence. This study provided evidence for the associations between environmental exposure to Cd and blood pressures/HT which should be considered for future preventive measures.

Psychological distress, self-harm and attempted suicide in UK 17-year olds: prevalence and sociodemographic inequalities.

In a large (n = 10 103), nationally representative sample of 17-year-olds 16.1% had experienced high psychological distress in the past 30 days, 24.1% had self-harmed in the previous 12 months and 7.4% had ever attempted suicide. Females, White adolescents, sexual minorities and those from more socioeconomically disadvantaged families had worse mental health outcomes; with the exceptions of no detected differences in attempted suicide by ethnicity and in self-harm by socioeconomic position. Findings include a narrower gender gap in self-harm at age 17 (males 20.1%, females 28.2%) compared with at age 14 (males 8.5%; females 22.8%) and 2-4 times higher prevalence in sexual minority adolescents (39.3% high distress, 55.8% self-harmed, 21.7% attempted suicide compared with 13.4%, 20.5% and 5.8%, respectively, in heterosexual adolescents).

Diabetes prevalence and risk factors of early-onset adult diabetes: results from the Indonesian family life survey

ABSTRACT Background Diabetes is increasing rapidly in South-East Asia. Studies have reported typical risk factors associated with all-age adult diabetes and highlighted the roles of economic transition and childhood development factors in diabetes in later life. However, little is known about whether these factors were associated with young adult diabetes risk. Objectives The study has two main aims: (1) estimate diabetes prevalence among adult participants of the Indonesian Family Life Survey (IFLS), and (2) identify childhood development factors associated with early-onset adult diabetes (diagnosed between age 20 and 40) in Indonesia. Methods Data were taken from adults participating in 4th and 5th IFLS (in 2007 and 2014) and linked to childhood history from previous surveys. Diabetes was ascertained from self-report and HbA1c testing in a subsample. Diabetes prevalence rates were estimated by age and source of diagnosis. Cox regression analysis was applied to assess potential risk factors for early-onset adult diabetes. Results A total of 34,767 participants were included in the study. Crude total prevalence estimate from self-report was 2,3% and increased with age. Including HbA1c measurements yielded nearly eight times higher prevalence estimates, depending on age. The proportion of yet undiagnosed cases is considerably higher in young age groups. Regression analyses showed that urban childhood residence and high education increased early-onset diabetes risk by 50–70%. Sex, childhood general health, socio-economic level and starvation exposure were not associated with early-onset diabetes risk. Conclusion Remarkable differences between diabetes prevalence rates based on self-report and HbA1c measurement indicated the need for better diagnosis, especially in young adults. Urban childhood residence and high education increased early-onset adult diabetes risk. Incorporating these factors and diabetes awareness in existing child health programs, together with screening of individuals at risk, could improve early diabetes detection and prevention strategies among young urban Indonesian adults.

Assessment of work-related symptoms, perceived knowledge, and attitude among nail salon technicians.

Beauty is a Lebanese stereotype, as Lebanese women often feel urged to decorate themselves. Recent studies have raised concerns about nail salon technicians' (NSTs) health and safety issues. The aim of our study was to evaluate the occupational symptoms reported by NSTs, to assess their knowledge and document their awareness regarding hazardous chemicals found in nail cosmetics. NSTs completed a researcher-administered questionnaire. Data were gathered on sociodemographic characteristics, perceived knowledge, and safety issues. Work-related symptoms reported by NSTs were evaluated, and their responses were compared to those of the office employees. A total of 120 NSTs and 120 office employees were interviewed. Compared to the control group, NSTs reported a higher prevalence of work-related respiratory, dermal, and irritative symptoms, all significantly associated with smoking and a poor ventilation system. In addition, musculoskeletal complaints were common among NSTs and significantly linked to a poor ventilation system, an increased number of customers per day, and a longer service duration. Furthermore, a longer career duration was significantly associated with an increased prevalence of irritative symptoms. When a binary logistic regression was carried out, it demonstrated a 25 times higher prevalence of work-related symptoms among NSTs compared to the office employees. Interestingly, 84% of the respondents had an inaccurate knowledge of nail cosmetics' risks with their educational level acting as key factor. Based on these findings, it is warranted to perform a clinical assessment, implement a stringent regulatory framework, and improve knowledge toward nail cosmetics' risk.

Association of Body Mass Index and Waist to Hip Ratio With Gallstone Disease in Patients Visiting Rural Tertiary Care Center in North India

Introduction. In India the prevalence of gall stone disease varies in different parts of India. Malhotra in 1996 conducted an epidemiological study in Indian Railway employees and showed that North Indians has 7 times higher prevalence of gall stones compared to South Indian employees. It is said that Gall bladder is a disease of "Fatty, Fertile, Females in their Forties". In our daily routine we observe that it is found not only in fatty females but common in average built patients also. Material and Methods. Study includes patients visiting to BPS GMC Khanpur Kalan with diagnosis of gall stone diseases and operated at our center with sample size of 135. Body mass index (BMI) and Waist to Hip ratio are calculated using their standard formulas. All data was compiled in IBM SPSS statistics (20.0). Result. Normal BMI is considered up to 25 and more than 50% patients lie in normal BMI range. Only 13% of cases lie in obese group that is BMI greater than 30. Waist to hip ratio, maximum patients that is BMI greater than 30. Waist to hip ratio, maximum patients that is (83%) lie in group more than 0.85. Minimum Waist to Hip ratio is .77 and maximum Waist to Hip ratio is 1.45. Out of 135 patients 90 patients are having high Waist to Hip ratio. Conclusion. Waist to Hip Ratio (abdominal adiposity) is better indicator of Gall stone diseases than BMI.

Association of Cow's Milk Protein Allergy Prevalence With Socioeconomic Status in a Cohort of Chilean Infants.

The aim of the study was to compare the cow's milk protein allergy (CMPA) prevalence in 2 cohorts of children from different socioeconomic strata. Prospective birth cohort that included patients from 2 hospitals providing care for a low- and high-income population, respectively. Healthy newborns ≥34 gestational weeks were recruited and followed up to 12 months by a monthly telephone survey. If ≥2 predefined symptoms/signs suggestive of CMPA were detected, the patient was evaluated by a pediatric gastroenterologist. Diagnosis was confirmed by exclusion diet followed by open oral food challenge. Overall the prevalence of CMPA was 5.2%, with a 6 times higher prevalence in the high income cohort (9.2%) compared with the low-income group (1.5%; relative risk 6.2; 95% confidence interval 1.8-20.7; P = 0.0005). All the cases were non-immunoglobulin E-mediated with predominantly gastrointestinal symptoms. High-income cohort did have higher frequency of C-section, mother's previous chronic disease, mother's history of atopy/food allergy, older age, and higher educational level of parents. Parent smoking and presence of pets at home were more frequent in the low-income cohort. Multiple logistic regression showed that the high-income cohort did have older age and higher educational level of both parents. In these cohorts the prevalence of CMPA was higher than reported previously in other developing countries and significantly higher in the high-income group. Our findings were associated with sociodemographic characteristics of the parents.

Prevalence of antibodies against SARS-CoV-2 according to socioeconomic and ethnic status in a nationwide Brazilian survey.

ABSTRACTObjectives.To investigate socioeconomic and ethnic group inequalities in prevalence of antibodies against SARS-CoV-2 in the 27 federative units of Brazil.Methods.In this cross-sectional study, three household surveys were carried out on May 14-21, June 4-7, and June 21-24, 2020 in 133 Brazilian urban areas. Multi-stage sampling was used to select 250 individuals in each city to undergo a rapid antibody test. Subjects answered a questionnaire on household assets, schooling and self-reported skin color/ethnicity using the standard Brazilian classification in five categories: white, black, brown, Asian or indigenous. Principal component analyses of assets was used to classify socioeconomic position into five wealth quintiles. Poisson regression was used for the analyses.Results.25 025 subjects were tested in the first, 31 165 in the second, and 33 207 in the third wave of the survey, with prevalence of positive results equal to 1.4%, 2.4%, and 2.9% respectively. Individuals in the poorest quintile were 2.16 times (95% confidence interval 1.86; 2.51) more likely to test positive than those in the wealthiest quintile, and those with 12 or more years of schooling had lower prevalence than subjects with less education. Indigenous individuals had 4.71 (3.65; 6.08) times higher prevalence than whites, as did those with black or brown skin color. Adjustment for region of the country reduced the prevalence ratios according to wealth, education and ethnicity, but results remained statistically significant.Conclusions.The prevalence of antibodies against SARS-CoV-2 in Brazil shows steep class and ethnic gradients, with lowest risks among white, educated and wealthy individuals.

Leisure-time physical activity and sports in the Brazilian population: A social disparity analysis.

ObjectivesTo estimate the prevalence of leisure-time physical activity (LTPA) or sports in the Brazilian population according to demographic and income variables.MethodsData from 60,202 Brazilian individuals (18 years and over) were analyzed, belonging to the National Health Survey 2013 sample. The prevalence of different modalities of LTPA and sports was estimated according to age, sex, skin color and income. The adjusted prevalence ratios were estimated by Poisson regression.ResultsOf every thousand Brazilians, 695 do not practice LTPA or sports. Walking is the most practiced LTPA (98/1000), followed by soccer (68/1000) and weight training (45/1000). For poor and black men, the most frequent LTPA was soccer, and, for women, gymnastics and walking. The prevalence of weight training and gymnastics was higher for white people compared with black people. All LTPA practices were more prevalent in individuals with higher income, except for soccer. Running on a treadmill and weight training had, respectively, 24.7 and 6.4 times higher prevalence in the richer quartile.ConclusionsThe study allowed identifying the type of LTPA and sport reported as the most frequent by the Brazilian population according to age, sex, skin color, and income, detecting strong social disparities in these practices.

Abstract P2059: American Medical Students Have a Higher Prevalence of Stage 2 Hypertension Than the General Public: A Cross Sectional Study

Relevance: Per the National Center for Health Statistics, 7.5% of U.S. adults between 18-39 years of age have stage 2 hypertension (HTN) under 2017 ACC/AHA guidelines. Research on HTN involving American medical students is lacking. This is one of the earliest known studies to survey blood pressures and associated risk factors of American medical students. Objective(s): The aim of this study is to determine the prevalence of HTN in first and second year medical students and identify risk factors that could be specific to all American medical students. Materials and Methods: Students from The DeBusk College of Osteopathic Medicine completed a survey that queried age, gender, tobacco use, alcohol consumption, diet, aerobic exercise, mental health, social support, and past medical history. Omron BP710N sphygmomanometers were used to measure blood pressures in the left arm. Waist circumference was measured around the umbilicus. HTN stages were defined under 2017 ACC/AHA guidelines. A multinomial regression analysis was performed in SPSS v22.0 with α = 0.05 to assess risk factors for the different stages of HTN. Results: Of the 213 students surveyed, 49.8% (106/213) were males and 49.3% (105/213) were females. Mean age of the sample was 25.8 years and the range was between 21-37 years. Under 2017 ACC/AHA guidelines 36.6% were (78/213) were normotensive; 16.4% (35/213) had prehypertension; 29.1% (62/213) had stage 1 HTN; and 17.8% (38/213) had stage 2 HTN. The regression model was significant, χ 2 (51) = 132.003, p &lt; .001, explained 51.6% (Nagelkerke R 2 ) of the variance in HTN, and correctly classified 57.4% of cases. Males were 13.26 times more likely (p&lt;0.001) to develop prehypertension than women. Increasing waist circumference by 1 inch was associated with an 11% increase in developing stage 2 HTN (p&lt;0.001). Conclusion: Medical students have a ~2.4 times higher prevalence of stage 2 HTN than the public. Anxiety, exercise, and diet were insignificant factors according to the regression model while gender, waist circumference, and amount of sleep were significant. Additional studies should be conducted to assess the prevalence of stage 2 HTN and develop a better understanding of what risk factors may be causing the increased prevalence of stage 2 HTN in medical students.

DOZ047.32: Infantile hypertrophic pyloric stenosis in patients with esophageal atresia: proposal for a causative seesaw model

Abstract Aim of the Study Patients born with esophageal atresia (EA) appear to have a 30 times higher prevalence of infantile hypertrophic pyloric stenosis (IHPS). This makes sense from a developmental perspective as both the esophagus and the pyloric sphincter are foregut derived structures. We hypothesized that genetic defects, disturbing foregut morphogenesis, are responsible for the specific combination of EA and IHPS. Methods Patients with both EA and IHPS born between 1970 and 2017 and where possible their parents were included. This study was approved by the internal review board of the Erasmus MC. After parental written informed consent, we determined genetic profiles with whole exome sequencing and SNP-array-based copy number variation analysis. We focused on (1) genetic variation in known EA and IHPS disease genes, (2) pathways important for foregut morphogenesis, (3) shared rare genetic variation, and (4) ultrarare variants in variant-intolerant genes, which have a high chance of being de novo. Segregation analysis of possible candidate variants was performed. Results Twenty-seven out of 664 patients (4.1%) born with EA during the study period developed IHPS, of which 15 cases were analyzed. As none of the parents were affected, we considered dominant (de novo) or recessive and X-linked inheritance models. Unfortunately, we could neither identify rare de novo mutations, nor variants fitting a recessive model. We did however identify inherited putative deleterious heterozygous variants in genes either known to be involved in EA or IHPS (e.g., COL7A1, TNXB, WDR11, GDF6) or important in foregut morphogenesis (e.g., GLI3, NKX2.1) in all patients. Moreover, seven genes were affected by rare variation in ≥2 patients (ADAMTSL4, ANKRD26, CNTN2, HSPG2, KCNN3, LDB3, SEC16B) and expressed in the developing foregut, esophagus or pyloric sphincter in mice between E8.25 and E18.5. However, burden analysis did not show a significant difference with unaffected controls. Conclusions Although the presence of genetic variation in likely candidate genes suggests a genetic component, genetic factors alone could not explain the abnormalities seen in these patients. Therefore, we propose a multifactorial model in which the combination of high impact genetic, mechanical, and environmental factors together can shift the balance from normal to abnormal development.