Relation among personality and symptoms in nonulcer dyspepsia and the irritable bowel syndrome

The importance of personality traits in nonulcer dyspepsia and irritable bowel syndrome is a controversial issue. We wished to assess the distribution of abnormal personality traits in nonulcer dyspepsia and the irritable bowel syndrome, define any relation among personality and symptoms, and determine whether personality factors discriminate among patients with functional, psychiatric, or organic gastrointestinal diseases. Patients with nonulcer dyspepsia (n = 31), irritable bowel syndrome (n = 67), organic gastrointestinal disease (n = 64), somatoform disorder (n = 36) and healthy controls (n = 128) were studied. Before diagnostic evaluation by an independent physician, all patients completed the Minnesota Multiphasic Personality Inventory and a symptom questionnaire. Symptom scores for abdominal pain and the Manning criteria, which is considered to be diagnostic for the irritable bowel syndrome, were evaluated. Personality scales in patients with nonulcer dyspepsia, irritable bowel syndrome, and organic disease were very similar. However, patients in the other groups differed from somatoform disorder on nearly all scales. In nonulcer dyspepsia, irritable bowel syndrome, and organic disease, hypochondriasis weakly correlated with pain. Subgroups of irritable bowel syndrome patients with predominant constipation and those with predominant diarrhea had similar personality traits, although hypomania was minimally increased in constipation. Patients who fulfilled the Manning criteria for irritable bowel syndrome had more psychological distress than those who did not. The Minnesota Multiphasic Personality Inventory correctly classified somatoform disorder and health 81% and 75% of the time, respectively, but it classified nonulcer dyspepsia and irritable bowel syndrome correctly in only 32% and 34% of cases. Our results suggest that psychopathology may not be the major explanation for functional gastrointestinal disorders.     

RECREATIONAL ACTIVITIES OF ELDERLY AUSTRALIANS CATEGORISED BY CARDIOVASCULAR STATUS

This study examines the participation in active and passive recreational activities among elderly Australians classified by cardiovascular status. The findings suggest that when an elderly person has a treated cardiovascular condition his/her participation in such activities does not differ from those who have no cardiovascular condition. It is also suggested, independent of cardiovascular status, that males belong to more clubs than females.     

Smoking decreases the duration of life lived with and without cardiovascular disease: a life course analysis of the Framingham Heart Study.

AIMS: To compare the burden of cardiovascular disease in terms of lifetime risk and life years lived with disease between smokers and non-smokers. METHODS AND RESULTS: We constructed multi-state life tables describing transitions through various cardiovascular diseases for 4723 smokers and non-smokers observed during 20 biannual observations in the Original Framingham Heart Study. Non-smokers live 8.66 (95% CI 7.61-9.63) (men) and 7.59 (95% CI 6.33-8.92) (women) years longer than smokers and more years free of cardiovascular disease: 6.22 (95% CI 5.09-7.30) years for males and 4.93 (95% CI 3.54-6.29) for females. But non-smokers spend more years with cardiovascular disease over the life course: 2.43 (95% CI 1.72-3.16) years for males and 2.66 (95% CI 1.87-3.38) years for females. The risk of cardiovascular disease before age 70 is higher among smokers, but over the entire lifecourse male non-smokers have higher risks of coronary heart disease, myocardial infarction, stroke and congestive heart failure, and female non-smokers have higher risks of coronary heart disease and congestive heart failure. CONCLUSION: Smoking, by shortening life, decreases both the probability and duration of cardiovascular disease throughout the life course. Non-smokers live many years longer and longer free of cardiovascular disease than smokers, but at the end of their life non-smokers will have lived longer with cardiovascular disease.     

Chronic kidney disease prevalence and trends (1998-2008) in an area of southern Italy. The data of the VIP project

Chronic kidney disease (CKD) is a common disorder whose prevalence is increasing worldwide. In Italy the prevalence of CKD, especially the early stages, is still not exactly known. Our study examines the prevalence and trends in ten years (1200 subjects in 1998-1999 and 1200 subjects in 2008-2009) of the estimated glomerular filtration rate (eGFR) in a population of southern Italy. We analyzed, within the VIP project, the prevalence of CKD (eGFR <60) in our area and its relationship to diabetes and hypertension as well as the trend between the years 1998-1999 and 2008-2009. The estimate of the GFR was obtained with the Cockcroft-Gault formula corrected for body surface area. The prevalence of CKD, stratified by the population of Campania, was about 5.9% in males and 3.9% in females in the years 1998-1999; ten years later (2008-2009) it had increased to 6.2% in males and 4.5% in females. The differences between males and females and between the two decades are not statistically significant although the trend shows a clear increase in subjects affected by CKD among both sexes. Among the male population the prevalence of CKD in persons with hypertension or diabetes, in those with both diseases, and in those free from these diseases was 11.2%, 12%, 13.8% and 6.3% (p=0.018), respectively. The same groups among females showed a CKD prevalence of 8%, 9.2%, 9.7% and 4.4%, respectively (p=0.042). Our work provides a picture of the prevalence of CKD in an area of southern Italy. It highlights the increase in CKD and calls upon a greater use of renal function tests in clinical practice, so that individuals at increased risk of developing cardiovascular complications may be detected as early as possible.     

The Effects of Human Papillomavirus Infection and Vaccination on Cardiovascular Diseases,NHANES 2003-2016

BackgroundHuman papillomavirus (HPV) infection has been proposed to be an unconventional risk factor for cardiovascular diseases. We investigated the association between HPV infection and cardiovascular diseases among women with or without HPV vaccination.MethodsThis cross-sectional study included 9,353 women aged between 20 to 59 years old who were tested for vaginal HPV DNA in the National Health and Nutrition Examination Survey (NHANES) 2003-2016. Cardiovascular diseases were defined as the presence of self-reported coronary heart diseases, heart attacks, angina pectoris, and stroke. The association between HPV and cardiovascular diseases was studied using logistic regression, with adjustment for the potential confounders.ResultsA total of 40.8% of women were HPV DNA positive; 3.0% had cardiovascular diseases; and 9.0% of women received the HPV vaccine. The presence of vaginal HPV infection was associated with cardiovascular diseases (odd ratio [OR] = 1.66, 95% confidence interval [CI] 1.28-2.16), which remained significant (OR = 1.54, 95% CI 1.15-2.08) after adjustment for sociodemographic characteristics, lifestyle behaviors, medical history, family history of cardiovascular diseases, and antihypertensive drugs. The association was absent among those who were vaccinated against HPV (OR= 0.50, 95% CI 0.07-3.51) but present among those who were not (OR = 1.63, 95% CI 1.18-2.25).ConclusionsThere was an association between HPV infection and cardiovascular diseases. This association was not significant among women vaccinated against HPV. The effect of HPV vaccination on cardiovascular diseases requires further investigation.     

Thyroid autoimmunity and cardiovascular diseases

The relationship of thyroid autoantibodies and elevated TSHlevel to indices of cardiovascular diseases was studied in twopopulation series monitored for 5 years and in a cross-sectionalhospital series. In a cohort of 1105 males, initially 55-74years of age, deaths due to cardiovascular causes occurred in19% of subjects with thyroid autoantibodies and in 11% of controlsmatched for age (P<0-05). In another cohort of 1045 malesand 1223 females, initially 40-64 years of age, no differenceemerged in males, while 6 out of 20 females who died of cardiovascularcauses had thyroid autoantibodies, compared with 18% in thewhole series. In a series of 97 hospital patients with myocardialinfarction, 7 patients had thyroid autoantibodies as opposedto 12 antibody-positive subjects among controls matched forage and sex. Elevated TSH level appeared to be no better anindicator of cardiovascular morbidity or mortality than thyroidautoantibodies. It is concluded that thyroid autoimmunity mayact as a cardiovascular risk factor under certain circumstances,but it does not have any general significance and the mechanismof action remains unclear.     

The significance of hypertensive response to exercise as a predictor of hypertension and cardiovascular disease

Several studies have shown that exaggerated blood pressure (BP) response to exercise can predict the development of hypertension and target organ damage, but others did not. The aim of this study was to evaluate the relationship between exaggerated BP response to exercise (ExBPR) and the development of hypertension or cardiovascular disease. We reviewed the charts of male subjects who, during the years 1991-1994, had a routine check up that included an exercise stress-test. For each subject, the following parameters were noted: age; body mass index (BMI); history of diabetes; cigarette smoking; family history of ischaemic heart disease and lipid profile. BP and heart rate at rest and during exercise were recorded as well. ExBPR was defined whenever peak exercise systolic BP or diastolic BP was over 200 mm Hg or 100 mm Hg respectively. We identified 73 males who exhibited ExBPR and matched them with a control group of 117 subjects with similar age who had a normal BP response. The mean age of the studied group was 42.6 years and the average follow-up was 5.7 years. Baseline characteristics were similar in both groups. During the follow-up we observed hypertension among 22% in those with ExBPR in contrast to 2.6% in the control group (P < 0.0001). In addition, more subjects of the ExBPR group required cardiovascular medications than of those in the control group (19.2% vs 4.3%, P = 0.0008). Thus, it seems that ExBPR predicts the development of hypertension and cardiovascular diseases. We therefore suggest that subjects with ExBPR should be followed more closely and be instructed for lifestyle modifications which may delay the development of such diseases.     

Influence of Antisocial and Psychopathic Traits on Decision-Making Biases in Alcoholics

Background:  Although decision-making processes have become a principal target of study among addiction researchers, few studies have specifically examined decision-making among individuals with alcohol dependence (AD) and findings to date are mixed. The present study examined the relationship between AD and decision-making, and tested whether different facets of antisocial and psychopathic traits explain this association.
Methods:  Participants were men with AD ( n  =   22), AD and comorbid antisocial personality disorder (AD + ASPD; n  =   17), or a history of recreational alcohol use, but no current or lifetime symptoms of a substance use disorder, conduct disorder, or ASPD ( n  =   21). Decision-making was tested using the Iowa Gambling Task (IGT).
Results:  Across groups, participants reported similar levels of awareness of the contingencies of the task, but the AD groups with and without ASPD had poorer IGT performance compared with controls ( p  < 0.05). A block-by-block analysis revealed that while AD had slow but steady improvement across the task, AD + ASPD exhibited initial improvement followed by a significant decrease in advantageous decision-making during the last 20 trials ( p  < 0.05). This was further confirmed via evidence that impulsive/antisocial personality traits but not psychopathic traits mediated poor IGT performance beyond ASPD diagnosis.
Conclusions:  Alcohol-dependent males favored risky choices regardless of whether they met criteria for ASPD. However, decision-making deficits were more pronounced among those with ASPD, and personality traits characterized by impulsive and antisocial tendencies mediated the relationship between AD and decision-making.     

不同性别纳西族老年人心脑血管慢性病患病率及影响因素

目的 本研究通过对丽江地区老年人慢性病患病率情况进行调查,分析其影响因素,为丽江少数民族不同性别老年人口慢性病防治措施的制定提供参考.方法 2019年1月采用多阶段分层随机抽样方法抽样并进行问卷调查,调查内容包括人口学特征指标(性别、年龄、是否读过书、贫困、吸烟、饮酒、食用白肉、心脑血管疾病家族史、肥胖、中心性肥胖、睡...     

Triglyceride profile following oil administration

27 normolipaemic females (average age 33.5 years), 26 normolipaemic males (average age 40.2 years) and 29 male patients with cardiovascular diseases (average age 48.9 years) were examined. In all persons an oral tolerance test with 75% sunflower oil was performed. After 6 and 8 hours the control of the postprandial hypertriglyceridaemia was performed. The average fasting values and the postprandial deviations show a clear degradation--females, males, patients with cardiovascular diseases. Between the size of the triglyceride deviation after load with edible oil and the HDL-cholesterol concentration in the fasting serum there is a significant negative correlation in patients with cardiovascular diseases and in normolipaemic males, which is not to be recognized in the group of the normolipaemic females. The authors are of the opinion that HDL cholesterol is also an indicator for the speed of the destruction of triglyceride-rich lipoproteins. At the end of a 4-week swimming training of 20-30 minutes a day, 6 times a week, in the patients with cardiovascular diseases a significantly improved fat tolerance and thus a round increase of the lipolytic capacity could be proved.     

Co-occurrence of obsessive-compulsive personality traits in young and middle-aged Japanese alcohol-dependent men

BACKGROUND: Previous studies may have underestimated the potential importance of the prevalence of obsessive-compulsive traits among persons with alcoholism. Although many studies have examined the characteristics of young alcoholics compared with middle-aged alcoholics, none has compared the prevalence of obsessive-compulsive traits in young and middle-aged alcoholics. METHODS: This study compared the prevalence of obsessive-compulsive traits (Leyton Obsessional Inventory) and depressive symptoms (Zung Self-Rating Depression Scale) among young (n=41) and middle-aged (n=34) hospitalized Japanese male alcoholics and in young (n=28) and middle-aged (n=25) nonalcoholic subjects. RESULTS: Both young and middle-aged male alcoholics reported more obsessive-compulsive personality traits and depressive symptoms than their comparison groups. However, the alcoholic subjects' obsessive-compulsive personality traits were not related to their level of depressive symptoms. CONCLUSIONS: Young and middle-aged male Japanese alcoholics have more obsessive-compulsive personality traits than nonalcoholic males of similar ages. Their alcohol-related psychological and behavioral characteristics may derive, in part, from their obsessive-compulsive symptoms.     

Tenderness and pain in neck and shoulders in relation to Type A behaviour

158 males employees in the metal industry, aged 35-44 years, were examined to determine the prevalence of tenderness and pain in the neck and shoulders. Type A behaviour was assessed by a series of 16 questions. One or more tender sites were found in 30% and more than three in 7% of the examined employees. Tenderness was twice as common among those with interview-based pain in the past 12 months (40%) as among those without pain (23%). Those with tenderness on palpation more often had a type A behaviour than those without tenderness (p = 0.010). The association was modified by pain but not by occupation. One explanation for the association between tenderness and behaviour might be that type A personality is associated with increased muscle activity in the neck and shoulders leading to muscular fatigue and tenderness.     

Association of geriatric conditions and cardiovascular diseases with disability in older adults with diabetes: Findings from a nationally representative survey

Aim: To examine how diabetes in combination with cardiovascular diseases (hypertension, heart disease and stroke) and geriatric conditions (cognitive impairment and depressive symptoms) affects the odds of disability in older adults. Methods: We analyzed data from a nationally representative sample of people aged 65 years and over (n = 2727) participating in the 2005 National Health Interview Survey in Taiwan. A total of 473 participants had a history of self‐reported physician diagnosed diabetes. Disability was defined as reporting limitations in one or more tasks of activities of daily living (ADL), instrumental activities of daily living (IADL) or general physical activities (GPA). The Mini‐Mental State Examination was used to assess cognitive function. The Center for Epidemiologic Studies Depression Scale was used to assess depressive symptoms. Results: After adjustment for other factors, cardiovascular diseases and geriatric conditions independently contributed to the excess odds of disability among participants with diabetes. Participants who had diabetes combined with cardiovascular diseases and geriatric conditions had odds ratios for ADL, IADL and GPA disability of 18.02 (95% CI 5.13–63.34), 7.95 (95% CI 4.07–15.50) and 5.89 (95% CI 3.19–10.90), respectively. Conclusion: Our results highlight the high prevalence of co‐occurrence of cardiovascular diseases with geriatric conditions in people with diabetes. Furthermore, the combined presence of these diseases and conditions is strongly associated with an excess odds of disability. These findings highlight the critical importance of preventing cardiovascular disease morbidity, and improving depressed mood and cognitive function in order to reduce disability risk in older adults with diabetes. Geriatr Gerontol Int 2013; 13: 563–570.     

A cross-sectional survey to evaluate the cardiovascular risk profile in subjects referred to the Verona-ASL 20 general practitioners]

BACKGROUND: Most of the studies on the identification of cardiovascular risk factors have been conducted either in northern Europe or in the United States. However, genetic as well as dietary factors may vary across different countries and geographical areas and there are few data about the cardiovascular risk profile in our country. METHODS: A sample of 3144 subjects (1463 males, 1681 females aged 35-74 years) were randomly selected among the population qualifying for healthcare assistance, registered with 170 general practitioners. Demographic data, clinical information, lab tests and current pharmacological treatments were collected using an electronic case report form. RESULTS: The prevalences of cardiovascular risk factors in the population were: smoking habit 22.7%, obesity 12.8%, hypertension 39.2%, hypercholesterolemia 25.5%, hyperglycemia and diabetes 5.5%. Thirty-five point four percent of the subjects presented a low absolute 10-year cardiovascular risk level (< 5%), 31.1% an intermediate risk (5-9%), 24.9% a moderate risk (10-19%), and 8.6% a high risk (> or = 20%) of developing cardiovascular diseases. CONCLUSIONS: In the area of Verona approximately 20,000 out of 231,592 subjects, aged 35-74 years, may present an absolute 10-year cardiovascular risk level > or = 20%. These results represent the epidemiological basis for planning and implementing preventive interventions toward cardiovascular diseases.     

Impact of sex, metabolic syndrome, and diabetes mellitus on cardiovascular events

Although cardiovascular events occur more frequently among patients with metabolic syndrome (MS) or diabetes mellitus (DM), the impact of gender is unclear. We aimed to determine the relation of MS and DM on cardiovascular events between men and women. The National Health Survey of 1992 provided information on outcomes for 3,414 Singaporeans aged 18 to 69 years without cardiovascular diseases. Definition of MS was based on the National Cholesterol Education Program criteria. Cardiovascular events included hospital admissions for coronary heart disease, stroke, and cardiovascular mortality. The proportion of subjects with MS was 12.4%. After 10 years, the annual cardiovascular event rates (per 1,000 person-years) for men without DM were 3.0 and 15.9 among subjects without and with MS, respectively, and the respective rates for men with DM were 22.5 and 21.4. The corresponding rates for women were 0.9, 3.7, 5.3, and 21.5, respectively. Among nondiabetic subjects, cardiovascular events occurred more frequently among men than women among subjects with MS (adjusted hazard ratios [HRs] 4.71, 95% confidence interval [CI] 1.56 to 14.2) and those without MS (HR 3.35, 95% CI 1.78 to 6.31). Among patients with DM, cardiovascular events occurred more commonly among men than women without MS (HR 6.04, 95% CI 1.43 to 25.6). Rates for cardiovascular events were comparable between men and women with DM and MS (HR 0.98, 95% CI 0.48 to 1.99). In conclusion, the adverse impact of MS or DM was greater among men, and the presence of both conditions increases the risk substantially for cardiovascular events among women.     

院前猝死事件发生的特点与复苏

目的:分析院前猝死事件发生的特点及有效防治措施。方法:回顾性分析我院2002年1月～2004年12月院前急诊救治的病例5682例的临床资料。结果:院前猝死病例247例,约72%有明确心血管病史,高发年龄为60岁以上,男性多于女性,冬季明显高于其他季节,夜间多发。引起猝死的直接原因:室颤、室速(77%)。结论:对于已有心血管病基础的患者应注意其发生猝死的高度危险性,加快普及现场第一目击者的心肺复苏术(CPR)技能、意识及公众场合普及自动除颤仪(AED)是刻不容缓的。     

Cardiovascular disease epidemiology and risk factors in primary care

INTRODUCTION AND OBJECTIVES: To study the prevalence of and risk factors for cardiovascular disease in primary care. PATIENTS AND METHOD: A cross-sectional study was carried out at an urban health center in Barcelona, Spain. In total, 2248 patients > or =15 years old were selected randomly from medical records. The study investigated cardiovascular diseases such as ischemic heart disease, cerebrovascular disease and peripheral arterial disease, and cardiovascular risk factors such as age, sex, smoking, high blood pressure, hypercholesterolemia, hypertriglyceridemia, and diabetes mellitus. RESULTS: The patients' mean age was 49.1 (18.9) years and 53.5% were male. Cardiovascular risk factor prevalences were: smoking, 35.2%; high blood pressure, 33.7%; hypercholesterolemia, 21.9%; hypertriglyceridemia,12.7%; and diabetes mellitus, 15.8%. Overall, 57.9% of patients had at least 1 cardiovascular risk factor. Significantly more males presented with each risk factor (P<.05), apart from high blood pressure. The prevalence of all risk factors, except smoking, increased with age until 74 years and then stabilized, except high blood pressure, which continued to increase. Around 10% had cardiovascular disease, with myocardial ischemia in 5.5%, cerebrovascular disease in 3.7%, and peripheral arterial disease in 2.4%. All except cerebrovascular disease were significantly more common in males (P<.05). The prevalence of cardiovascular disease was low in individuals <55 years old, particularly women, and increased with age for all forms of disease. Some 68.3% were > or =65 years old. CONCLUSIONS: The high prevalence of cardiovascular risk factors was confirmed. Cardiovascular disease was more common in males and the elderly.     

Alcohol-Related Aggression in Males and Females: Effects of Blood Alcohol Concentration, Subjective Intoxication, Personality, and Provocation

This study tested the combined predictive ability of blood alcohol concentration (BAC), subjective intoxication, and aggressive personality traits on physical aggression in males and females in Highland Low-provocation conditions. Sixty intoxicated White social drinkers (30 males and 30 females) competed against a fictitious opponent on a modified version of the Taylor aggression paradigm in which subjects both received and delivered electric shocks to their opponents in provoking and nonprovoking conditions. Provocation conditions (High and Low) were defined by the intensity of the shocks the subjects received. Aggression was operationalized as the intensity of the shocks selected by the subjects. Results indicated that, for males in the High-provocation condition, aggressive personality traits, subjective intoxication, and BAC were effective predictors of physical aggression. However, in the Low-provocation condition, only aggressive personality traits and BAC predicted aggression. None of the variables were effective predictors of aggression for intoxicated females.     

Der Tod im Sport—ein internistisches Problem?

Sports means fitness and endurance, regeneration and balance, game and fun. Lack of physical exercise is one of the main risk factors for cardiovascular diseases. Terrifying and not conclusive in the public's mind are events of sudden death, in particular if those are of nontraumatic cause and thus of cardiovascular origin. Organic pathologic examination revealed that a higher proportion of males are affected by sports death. Only 7-9% of those events are related to women, although the percentage of active women among sports people accounts for nearly 50%. The relative risk increases with age and intensity of endurance. For people who are untrained or not used to train, the risk of sudden death is potentially higher. In athletes > 35 years of age, coronary artery disease (CAD) is the most common cause (85%) of sudden death. In the group < 35 years, CAD and acute myocarditis are the predominant causes of sudden death, but also hypertrophic cardiomyopathy (HCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), disorders of the conducting system, and Marfan's syndrome. Additional risk factors like acute infections and misuse of doping drugs require the care of a specialist in internal medicine and/or cardiology on top of the care by a specialist in orthopedics and accident/rehabilitation medicine. Physical examination as a precaution and prevention strategy should be available for leisure sports as well as for athlete sports.     

上海市金山区晚期血吸虫病患者死因分析

目的 掌握金山区晚期血吸虫病(简称晚血)患者死亡的基本情况,并对死亡的原因进行分析,为科学动态管理晚血患者和制定专项救治方案提供依据.方法 对金山区2007—2019年晚血患者随访数据库进行整理,对全区晚血患者死亡趋势以及历史在册晚血患者和新增晚血患者的死因进行分析.结果 2007—2019年,全区晚血患者病死率呈现波...