Prevalence and correlates of Benign Pancreatic Hyperenzymemia in a large general population sample: The Damocles sword perception

Background

Benign Pancreatic Hyperenzymemia (BPH) is characterized by a long-term increase of serum pancreatic enzymes (PE) in otherwise healthy subjects. The study investigates the prevalence and correlates of the condition using data from Electronic Health Records (EHR) in a large sample of general population, to identify subjects potentially affected by BPH.

Prevalence of primary aldosteronism without hypertension in the general population: Results in Shika study

Objective: Recent studies have reported a high prevalence of primary aldosteronism (PA) among hypertensive patients. However, few data exist regarding the prevalence of PA in the general population. Therefore, we examined the prevalence of PA in the general population including normotensive subjects. Methods: Plasma renin activity (ng/mL/hr), plasma aldosterone concentration (pg/mL) and aldosterone renin ratio (ARR) were determined in 309 subjects aged >40 years in Horimatsu and Higashi-Matsuho district, Shika-machi, Ishikawa, Japan. Results: Among them, 195 subjects (78 males, mean age: 62 ± 11 years) did not take antihypertensive agents: 113 normotensive subjects and 82 hypertensive subjects. Under these conditions, 68 subjects (13 males, age 62 ± 10 years) had an ARR >200. In 14 subjects who underwent captopril suppression test, PA was documented in 5 subjects, yielding a minimum prevalence of 2.6% in total subjects (1.8% in normotensive subjects and 3.7% in hypertensive subjects). Interestingly, females subjects demonstrated significant differences in ARR between subjects with age <50 (172 ± 105) and those with age 51–60 (388 ± 531), although there were no differences in male subjects. Conclusions: These results demonstrate that PA including normotensive subjects exists more commonly than that expected in the general population. We suggest further investigation about the cause and progression of PA associated with sex and aging.     

Long‐term outcome of intraventricular conduction delays in the general population

BackgroundPrevious population studies have presented conflicting results regarding the prognostic impact of intraventricular conduction delays (IVCD).MethodsWe studied long‐term prognostic impact and the association with comorbidities of eight IVCDs in a random sample of 6,299 Finnish subjects (2,857 men and 3,442 women, mean age 52.8, SD 14.9 years) aged 30 or over who participated in the health examination including 12‐lead ECG. For left bundle branch block (LBBB) and non‐specific IVCD (NSIVCD), two different definitions were used.ResultsDuring 16.5 years’ follow‐up, 1,309 of the 6,299 subjects (20.8%) died and of these 655 (10.4%) were cardiovascular (CV) deaths. After controlling for known clinical risk factors, the hazard ratio for CV death, compared with individuals without IVCD, was 1.55 for the Minnesota definition of LBBB (95% confidence interval 1.04–2.31, p = .032) and 1.27 (95% confidence interval 0.80–2.02, p = .308) for the Strauss’ definition of LBBB. Subjects with NSIVCD were associated with twofold to threefold increase in CV mortality depending on the definition. While right bundle branch block, left anterior fascicular block and incomplete bundle branch blocks were associated with seemingly higher mortality, this was no longer the case after adjustment for age and sex. The presence of R‐R’ pattern was not associated with any adverse outcome.ConclusionsIn a population study with long‐term follow‐up, NSIVCD and Minnesota definition of LBBB were independently associated with CV mortality. Other IVCDs had no significant impact on prognosis. The prognostic impact of LBBB and NSIVCD was affected by the definition of the conduction disorder.     

嘉兴市秀洲区一般人群的梅毒感染情况

目的了解嘉兴市秀洲区一般人群中梅毒感染的情况和分布特征,为制定辖区梅毒综合防治措施提供参考。方法结合秀洲区一般人群健康体检工作进行连续性采样,对收集到的血清样本采用快速血浆反应素环状卡片试验（RPR）检测,以筛查人群梅毒感染状况。对阳性样本采用梅毒螺旋体明胶凝集试验（TPPA）进行确证。结果一般人群中梅毒感染率为0.89%（116/13 006）。感染者较集中于20～49岁人群,占总数58.62%;50～岁组出现感染率下降,但60～岁以上组出现感染率二次小高峰,且男性感染率高于女性。结论梅毒在一般人群中感染率较高,建议加大辖区居民中20～49岁组及60～岁组人群的梅毒等性病相关知识的宣传和行为矫正,推广使用安全套,纠正不安全性行为,规范性病诊疗,防止梅毒在人群中进一步蔓延。     

On the role of ventricular conduction time in rate stabilization for atrial fibrillation.

AIM: Ventricular pacing (VP) could stabilize the ventricular rhythm in atrial fibrillation (AF). This study investigates the role of ventricular conduction time (VCT) in rate stabilization for AF. METHODS AND RESULTS: A novel computer model was used to generate various patterns of RR intervals in AF. For each model configuration, the rate stabilization effect of VP was compared with respect to different VCTs. In all tested cases, the ventricular rate in AF could be stabilized at pacing intervals longer than the shortest spontaneous RR intervals. For each model configuration, slightly longer pacing interval (difference <100 ms) was needed to achieve 95% VP when the antegrade/retrograde VCT was increased from 10/10 to 110/110 ms, whereas the VCT had less effect at lower pacing rate. Although longer VCT was associated with increased percentage of ventricular fusion, its role was diminished at higher pacing rate when more retrograde waves could conduct to the atrium. CONCLUSION: Ventricular conduction time has limited effects on rate stabilization, which could be explained by multi-level interactions between antegrade waves induced by AF and retrograde waves induced by VP.     

Prevalence and associated factors for self-reported asthma in a Canadian population: The Canadian Community Health Survey, 2014

Background: Asthma prevalence is increasing among adults, yet limited information regarding the association between adult asthma and environmental and personal exposures is available using large nationally representative population-based survey. Objective: To determine the prevalence of asthma and associated factors for self-reported asthma in a Canadian population aged 12 years and older by using the Canadian Community Health Survey (CCHS) 2014 cross-sectional cohort. Methods: We used data from the 2014 CCHS. Asthma was determined through self-reported health professional diagnosis. Information regarding covariates of importance, such as socio-economic status, life style variables, was obtained. A weighted logistic regression analysis was performed with appropriate technique for clustering effects. Results: Estimated self-reported asthma prevalence of 8.1% in the greater than 12 years old Canadian population was observed. We found that a substantial proportion of Canadians (aged 12 and older) reported having asthma and geographical differences and differences between specific provinces in asthma prevalence. Women had higher prevalence of asthma than men, but the relationship depended on age and body mass index (BMI). Interactions between household income and smoking status were observed to predict the probability of asthma. Conclusions: Additional studies are needed to determine which factors influence the asthma prevalence between sex, BMI as well as smoking status and household income and its interactions with each other.     

Prevalence of left ventricular diastolic dysfunction in the community. Results from a Doppler echocardiographic-based survey of a population sample.

AIMS: The prevalence of left ventricular diastolic abnormalities in the general population is largely unclear. Thus, the aim of this study was, firstly, to identify abnormal diastolic function by echocardiography in an age-stratified population-based European sample (MONICA Augsburg, n=1274, 25 to 75 years, mean 51+/-14) and, secondly, to analyse clinical and anthropometric parameters associated with diastolic abnormalities. METHODS AND RESULTS: The overall prevalence of diastolic abnormalities, as defined by the European Study Group on Diastolic Heart Failure (i.e. age dependent isovolumic relaxation time (92-105 ms) and early (E-wave) and late (A-wave) left ventricular filling (E/A-ratio, 1-0.5)) was 11.1%. When only subjects treated with diuretics or with left atrial enlargement were considered (suggesting diastolic dysfunction) the prevalence was 3.1%. The prevalence of diastolic abnormalities varied according to age: from 2.8% in individuals aged 25-35 years to 15.8% among those older than 65 years (P<0.01). Significantly higher rates of diastolic abnormalities were observed in men as compared to women (13.8% vs 8.6%, P<0.01). Independent predictors of diastolic abnormalities were arterial hypertension, evidence of left ventricular (LV) hypertrophy, and coronary artery disease. Interestingly, in the absence of these predisposing conditions, diastolic abnormalities (4.3%) or diastolic dysfunction (1.1%) were rare, even in subjects older than 50 years of age (4.6%) and (1.2%), respectively. In addition to these factors, diastolic dysfunction was related to high body mass index, high body fat mass, and diabetes mellitus. CONCLUSION: The prevalences of diastolic abnormalities and diastolic dysfunction are higher than that of systolic dysfunction and are increased (despite age-dependent diagnostic criteria) in the elderly. However, in the absence of risk factors for diastolic abnormalities or diastolic dysfunction, namely LV hypertrophy, arterial hypertension, coronary artery disease, obesity and diabetes the condition is rare even in elderly subjects. These data allow speculation on whether diastolic heart failure may be prevented by improved implementation of measures directed against predisposing conditions.     

Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients

AIM To assess the prevalence of possible risk factors of upper gastrointestinal bleeding(UGIB) and their agegroup specific trend among the general population and osteoarthritis patients.METHODS We utilized data from the National Health InsuranceService that included claims data and results of the national health check-up program. Comorbid conditions(peptic ulcer, diabetes, liver disease, chronic renal failure, and gastroesophageal reflux disease), concomitant drugs(aspirin, clopidogrel, cilostazol, non-steroidal anti-inflammatory drugs, steroid, anticoagulants, and SSRI), personal habits(smoking, and alcohol consumption) were considered as possible UGIB risk factors. We randomly imputed the prevalence of infection in the data considering the age-specific prevalence of Helicobacter pylori(H. pylori) infection in Korea. The prevalence of various UGIB risk factors and the age-group specific trend of the prevalence were identified. Prevalence was compared between osteoarthritis patients and others.RESULTS A total of 801926 subjects(93855 osteoarthritis patients) aged 20 and above were included. The prevalence of individual and concurrent multiple risk factors became higher as the age increased. The prevalence of each comorbid condition and concomitant drug were higher in osteoarthritis patients. Thirty-five point zero two percent of the overall population and 68.50% of osteoarthritis patients had at least one or more risk factors of UGIB. The prevalence of individual and concurrent multiple risk factors in younger age groups were also substantial. Furthermore, when personal habits(smoking, and alcohol consumption) and H. pylori infection were included, the prevalence of concurrent multiple risk factors increased greatly even in younger age groups.CONCLUSION Prevalence of UGIB risk factors was high in elderly population, but was also considerable in younger population. Patient with osteoarthritis was at higher UGIB risk than those without osteoarthritis. Physicians s h o u ld c o n s id e r in d i v i d u a li z e d r i s k a s s e s s m e n t regardless of age when prescribing drugs or performing procedures that may increase the risk of UGIB, and take necessary measures to reduce modifiable risk factors such as H. pylori eradication or lifestyle counseling.     

快速心室率心房纤颤的房室传导改良

对１３例药物难以控制的快室率心房纤颤（房颤）病人进行经射频消融房室传导改良，射频消融靶点选择右房内房间隔之后、中或前部。射频能量为２０～３０Ｗ，平均发放射频８±３次。结果：９例房室改良成功，３例失败，１例于术后３天发生Ⅲ°房室传导阻滞。９例术后２天及２个月休息时心率、活动时心率、最高心率及最低心率较术前有明显下降（Ｐ＜０．０５）．１例于术后１１个月复发，其机理与部分或全部损伤后结间束或部分损伤房室结有关。认为射频消融房室传导改良为治疗药物难以控制的快室率房颤的一种相对安全有效的方法。     

Prevalence of left ventricular hypertrophy in a hypertensive population

AIMS: This investigation was set up to study the prevalence of leftventricular hypertrophy in a hypertensive population with referenceto a normotensive control group. From the general population3498 men and women aged 35, 45, 55 and 65 years old were invitedto a health examination. Participants with blood pressure above160 mmHg systolic or 95 mmHg diastolic or those taking antihypertensivemedication or having done so during the previous 6 months wereasked to undergo an echocardiographic examination. Normotensivecontrols were randomly selected from the same population. Of552 participants in the final study population, 194 were normotensivecontrols and 358 were in the hypertensive group. Echocardiographicmeasurements were made according to the Penn conventions andindexed for body surface. Cut-off values for left ventricularhypertrophy were 134 g. m^{– 2} for males and 102 g. m^–2 for women. RESULTS: Overall, the prevalence of left ventricular hypertrophy wasl4%/20% (men/women) in normotensives and 25%/26% in hypertensives(P<0·01). After subdivision by age and sex, therewas a significant difference in the prevalence of left ventricularhypertrophy between normotensives and hypertensives only inthe 65-year-old group (P<0·02 for males and P<0·05for females). CONCLUSION: The association between blood pressure and left ventricularhypertrophy in the general population is weak. Left ventricularhypertrophy is only significantly more frequent among hypertensivesas compared to normotensives in older people.     

Prevalence of metabolic syndrome in the general Japanese population in 2000

To determine the prevalence of metabolic syndrome in the Japanese general population, we analyzed data from a nationwide survey conducted in 2000. According to the Japanese new diagnostic criteria for metabolic syndrome in 2005, we analyzed 3,264 people aged from 20 to 79 (men, 1,917; women, 1,347) from the total participants. The incidence of metabolic syndrome was 7.8%. Men had a higher incidence (12.1%) than women (1.7%). Most of the women satisfying the criteria were 50 years old or over, while the incidence in men started to rise from their 30s. When we applied the criteria of Adult Treatment Panel III, the incidence was about 3-fold higher. In this population visceral obesity was associated with metabolic abnormalities, such as higher LDL-cholesterol, triglyceride, glucose, and blood pressure and lower HDL-cholesterol. Thus we determined the incidence of metabolic syndrome and each metabolic abnormality in the Japanese general population in 2000 and found an association of visceral obesity with metabolic abnormalities. Intervention to reduce the incidence of metabolic syndrome in Japan is necessary to reduce the risk of cardiovascular disease.     

Association of proteinuria with incident atrial fibrillation in the general Japanese population

BackgroundAlthough proteinuria has been associated with incident atrial fibrillation (AF) in Western countries, the association has not been investigated in the general Japanese population.MethodsParticipants aged ≥40 years who underwent the Japanese specific health check-up in Kanazawa City in 2013 and who completed a urine dipstick test were included in this study. Exposure was considered as presence or absence of proteinuria (≥1+). The outcome was incident AF confirmed by 12-lead electrocardiography. The Cox proportional hazard model was used to compute hazard ratio (HR) of proteinuria (≥1+) for incident AF after adjustment for traditional risk factors. We also completed stratified analyses by baseline characteristics.ResultsA total of 37,910 participants aged ≥40 years were included (mean age: 72.3 years, male sex: 37%). Proteinuria ≥1+ was observed in 2.765 (7.3%) participants. During a median follow-up period of 5 years, 708 incident AF cases were observed. Proteinuria ≥1+ was associated with incident AF (HR, 1.47: 95% confidence interval, 1.18–1.84) after covariate adjustment. Stratified analysis demonstrated that the association of proteinuria with AF was stronger in participants <75 years [HR 1.89 (95% CI 1.32–2.70)] compared with those ≥75 years [HR 1.27 (95% CI 0.95–1.69)] (interaction p-value = 0.02).ConclusionsProteinuria was significantly associated with incident AF in the general Japanese population. The evaluation of proteinuria using urine dipstick test may be useful in the evaluation of incident AF, especially in younger general population.     

房室传导不典型文氏现象的心电图特点及临床意义

目的探讨房室传导不典型文氏现象的心电图特点及临床意义。方法回顾性分析9例(其中男6例,女3例,年龄19～81岁)房室传导不典型文氏现象的临床资料。结果9例房室传导不典型文氏现象病例中,1例为单纯房室阻滞,1例交替性文氏传导,2例非交替性文氏传导,5例房室结双径路。其中4例为病理性阻滞伴严重器质性心脏病,其他为迷走高敏所致生理性阻滞。结论年轻患者不典型文氏型房室阻滞者以迷走高敏所致功能性阻滞多见,有器质性心脏病者发生不典型文氏现象时,心电图表现复杂并常与其他心律失常共存。     

新疆地区居民艾滋病相关知识 态度 行为调查分析

目的了解新疆地区不同人群艾滋病相关知识、行为、态度的现状,以及时发现工作中存在的薄弱环节和问题,控制艾滋病在当地的流行蔓延。方法采取现况流行病学调查方法,由培训合格的调查员对选取的239名居民进行面对面的问卷调查,用SPSS 13.0统计软件进行统计描述。结果新疆一般人群对艾滋病相关基本知识总知晓率为66.94%,艾滋病传播途径知晓率为76.23%,非传播途径知晓率为72.93%,预防艾滋病知识知晓率为51.70%,对感染者的态度正确率为83.27%。注射毒品者占14.64%,共用注射器的占12.97%。结论有针对性地制定艾滋病相关知识宣传教育计划,加强薄弱环节特别是少数民族地区,开发相应的语言文字的信息传播,使目标人群全面、正确地了解和掌握艾滋病防治知识,减少传播HIV的风险。