Overview of restless legs syndrome

Restless legs syndrome is a common movement and sleep disorder, which can significantly reduce quality of life. Restless legs syndrome is probably related to dopamine imbalance and may have a primary or secondary aetiology. It is greatly underdiagnosed, yet potentially treatable.     

Prospective study of restless legs syndrome and risk of depression in women

Children with asthma can experience chronic morbidity that may interfere with education and career progression. The authors investigated retrospectively whether a history of childhood asthma is associated with educational level and longest-held occupation, by gender. Cross-sectional analysis included a nationally representative sample of 10,452 adults aged ≥20 years who participated in the US National Health and Nutrition Examination Survey (2001-2004). Logistic regression was used to assess associations between a childhood-asthma history and educational level, employment, and longest-held occupation. An estimated 6.9% of men and 5.8% of women had a childhood-asthma history. Persons with a childhood-asthma history tended to have a higher educational level than those with no asthma history. Among those who ever worked, and after adjustment for age and race/ethnicity, men with a childhood-asthma history were more likely to work in health-diagnosing occupations, other professional occupations, and as cooks; women with a childhood-asthma history were more likely to work in management-related, entertainment-related, and health service occupations. Compared with those with no asthma history, persons with a childhood-asthma history tended to achieve a higher educational level and, if they worked, were more likely to work in particular occupations.     

上海市松江区某社区成年人慢性肾病流行现况调查

目的 了解上海市松江区某社区成年人慢性肾病（chronic kidney disease,CKD）的流行现况及主要相关因素。方法 采用随机整群抽样的方法抽取上海市松江区新桥镇20~75岁的常住居民9 257名进行CKD及其相关因素的问卷调查、体格检查及血尿常规、生化检测。结果 本次调查资料完整的对象共8 207名,经年龄和性别调整后,调查人群CKD患病率为8.4%（95% CI：7.8%~9.0%）,其中早期（Ⅰ~Ⅱ期）CKD患者占76.5%。随着年龄增加,CKD患病率逐渐升高且女性患病率明显高于男性（P<0.001）。多因素logistic回归分析显示,CKD与女性、≥ 60岁、高血压、高尿酸血症、高脂血症等因素独立相关。结论 上海市松江区某社区成年人CKD患病率较高,已成为松江区重要的公共卫生问题之一,且女性、≥ 60岁、高血压、高尿酸血症、高脂血症是CKD的相关因素。需重视CKD的早期防治,避免终末期肾脏病和相关并发症的发生。     

Prevalence of hypersensitivity reactions against drugs among adult population in Turkey: a self-reported survey

Aim

There is currently no data available regarding hypersensitivity reactions to drugs in an adult population in Turkey. The aim of this study was to determine the prevalence of self-reported drug hypersensitivity reactions among adults in Turkey and related factors.

Subjects and methods

A structured self-administered questionnaire was sent to the parents of 6th grade elementary students who represented different socioeconomic levels of populations in Ankara/Turkey.

Results

A total of 1,370 adults (mean age: 23.88?±?6.48?years, female/male: 710/660) responded to the survey. The prevalence of self-reported drug hypersensitivity was 13.4% (183/1,370). The most frequently drugs involved were beta-lactams (n?=?63, 34.4%), followed by nonsteroidal anti-inflammatory drugs (n?=?52, 28.4%), general anesthetics (n?=?29, 15.8%) and radio contrast media (n?=?25, 13.7%). Factors related with reported reactions were age (p?<?0.0001, odds ratio: 2.27); personal history of allergic (p: 0.001, odds ratio: 7.32), nonallergic diseases (p?<?0.0001, odds ratio: 39.93), and family history of drug hypersensitivity (p?<?0.0001, odds ratio: 17.00). Less than half of the subjects had solicited medical assistance during the acute stages of a reaction and 9.7% of them had been referred to an allergist for further evaluation of a drug allergy.

Conclusion

This survey showed that self-reported hypersensitivity reactions to drugs are highly prevalent among parents of elementary students and its prevalence seems to be affected by age, personal allergic and nonallergic diseases, and family history of drug hypersensitivity.     

Burden of restless legs syndrome on health-related quality of life

Objective To quantify the total and unique burden of Restless Legs Syndrome (RLS) on patient-reported health-related quality of life (HRQoL). Methods The disease burden that RLS places on HRQoL was estimated by comparing Short-Form (SF-36) scores between individuals with RLS and several patient and general populations in the US. Regression methods were applied to estimate SF-36 normative values from the general population sample and statistically adjust them to match age, gender and disease comorbidity characteristics of the RLS sample. Significance tests were then used to compare the means across samples. Results All SF-36 measures were significantly below adjusted US general population norms. Five of the eight scales (physical functioning, role physical, bodily pain, general health, vitality) were below US norms by 0.8 or more standard deviations (SD), while the remaining three (social functioning, role emotional, mental health) were 0.5 SD below norm. The burden of RLS was greater on physical than on mental/emotional HRQoL (physical and mental summary scores were 1.08 and 0.40 SD below norm, respectively), and greater than that observed for type-2 diabetes. Conclusion After controlling for the impact of age, gender, and disease comorbidity, RLS was associated with unique burden on both physical and mental aspects of HRQoL.     

Prevalence of the metabolic syndrome among a determined Puerto Rican population

The metabolic syndrome defined as diabetes, hypertension, obesity, dyslipidemia, Glucose intolerance and hyperinsulinemia, also known as the syndrome of insulin resistance, has been found highly prevalent among Hispanic populations. The reason is attributed to the high prevalence of obesity and diabetes due to genetic factors, sedentary lifestyle and poor nutritional habits. The association of the metabolic syndrome with cardiovascular disease is widely recognized but the prevalence of the syndrome varies between studies due to the variations among both definitions (ATP III and WHO). We aim to determine the prevalence of the metabolic syndrome in a determined Puerto Rican population at the outpatient employee's clinic to further support the burden of the metabolic syndrome among hispanics. In this study, the ATP III criteria presented higher prevalence of the metabolic syndrome than the WHO definition and the modified criteria detected more cases of impaired fasting glucose than ATP III. The 32% overall prevalence support the NHANES III reported prevalence among Mexican-Americans.     

No difference in efficacy of hydroquinine and placebo in restless legs syndrome

OBJECTIVE. Determination of the efficacy of hydroquinine treatment of the restless legs syndrome. DESIGN. Double blind cross-over trial. SETTING. University Hospital Leiden. PATIENTS AND METHODS. Selection through an announcement in the press and followed by structured interview. Inclusion criteria according to the international classification of sleep disorders. Exclusion criteria defined by medication risks. Patients used either hydroquinine (200 mg in the evening and 200 mg before going to bed) or placebo in the second and fourth of four periods of two weeks duration. Severity of complaints was assessed using a daily questionnaire and a Suggested Immobilization Test (SIT) twice weekly, in which they noted the severity of complaints as experienced during a 15-minute period of immobilization. RESULTS. The study was completed by 59 out of 68 patients. Analysis of variance showed no significant differences between the two groups of patients (those starting with placebo and those starting with hydroquinine) for any of the questions of the daily questionnaire or of the SIT. McNemar's test showed no significant differences between the proportions of patients who wished to continue the use of either placebo or hydroquinine. CONCLUSION. This study showed no significant differences between the efficacy of placebo or hydroquinine in the restless legs syndrome.     

宁夏农村地区回汉族成年人群代谢综合征流行病学调查

目的 调查宁夏农村地区回汉族成年人群代谢综合征(MS)的流行现况,评估不同MS诊断标准在宁夏农村地区成年人群中的运用价值.方法 采用分层整群抽样的方法 ,进行问卷调查,共调查1612人.对全部样本测定空腹血糖、血脂、BMI、血压等;用国际糖尿病联盟(IDF2005)和美国国家胆固醇教育计划成人治疗指南Ⅲ(ATPⅢ2005 AHA 修订)以及中国糖尿病联盟(CDs2004)诊断标准的MS定义对资料进行分析.结果宁夏农村地区回汉族成年人群三种标准MS标化患病率分别为15.00%(ATPⅢ2005 AHA 修订)、11.80%(IDF2005)和6.71%(CDs2004).按照IDF2005、ATPⅢ2005 AHA 修订的定义标准,回汉族成年人群MS标化患病率女性显著高于男性(16.3%vs.5.4%、18.9%vs.8.9%,P<0.01);但按照CDs2004标准研究发现男女性别间差异没有统计学意义(P>0.05);回族MS患病率均高于汉族(P<0.05).两民族MS患病率均随着年龄的增加而升高,而且回族在35岁后MS患病率均高于汉族.男性MS患病率两民族比较差异无统计学意义(P>0.05);女性MS患病率,回族显著高于汉族(P<0.05).结论 宁夏农村地区成年人群具有较高的MS患病率,不同民族的MS组分特点有较大差异,选择合适的MS诊断标准有利于该地区MS及心血管疾病的防治.     

妊娠女性体内铁含量对孕妇不宁腿综合征发病的影响

目的:探讨妊娠女性体内铁含量对孕妇不宁腿综合征发病的影响。方法:检测门诊孕期28周以上症状性不宁腿综合征孕妇、正常孕妇及健康女性体内血清铁、血清铁蛋白、血清可溶性转铁蛋白受体含量,并对检测结果做统计学分析。结果:血清铁、血清铁蛋白、血清可溶性转铁蛋白受体含量在症状性不宁腿综合征孕妇分别为(16.7±2.6)μmol/L、(29.3±3.2)μg/L和(38.2±8.5)nmol/L,在正常孕妇分别为(17.1±3.0)μmol/L、(30.2±4.4)μg/L和(36.0±6.3)nmol/L,在健康女性分别为(18.5±4.0)μmol/L、(36.8±5.9)μg/L和(27.9±4.3)nmol/L。症状性不宁腿综合征孕妇与健康女性在血清铁蛋白、血清可溶性转铁蛋白受体含量之间差异有统计学意义(P<0.01);不宁腿综合征孕妇与正常孕妇各检测指标之间差异无统计学意义。结论:妊娠女性体内铁缺乏可能是诱发孕妇发生不宁腿综合征的重要因素。     

Effect of nonergot dopamine agonists on symptoms of restless legs syndrome

PURPOSE We performed a meta-analysis of randomized placebo-controlled trials of nonergot dopamine agonists (NEDAs) for the treatment of restless legs syndrome.METHODS A systematic literature search was conducted through July 2007. The primary outcome measures assessed were the percentage of responders to medication as determined by the Clinical Global Impression-Improvement (CGI-I) scale and the adjusted mean change in the International Restless Legs Syndrome Study Group Scale (IRLS) score from baseline compared with placebo. Meta-regression analysis was performed to evaluate the impact of study duration on the primary outcomes. Safety endpoints were also evaluated.RESULTS A total of 14 trials (n = 3,197 subjects) were included in the meta-analysis. NEDA use resulted in greater response as measured by the CGI-I scale (relative risk [RR] 1.36; 95% CI, 1.24 to 1.49; P <.001), and greater reductions in IRLS scores (weighted mean difference [WMD] −4.93; 95% CI, −6.42 to −3.43; P <.001) from baseline vs placebo. Meta-regression analysis showed an inverse relationship between study duration and reduction in IRLS score. NEDAs were associated with a significant risk of adverse events (including nausea, dizziness, somnolence, and fatigue.)CONCLUSIONS Use of NEDAs in patients with moderate-to-severe restless legs syndrome results in significant reductions in symptom severity, but a significant portion of patients will discontinue their use as a result of adverse events.     

老年男性不宁腿综合征危险因素的病例对照研究

目的 探讨老年男性不宁腿综合征(RLS)的危险因素.方法 采用病例对照研究,病例组(148例)为确诊的老年男性RLS患者,按照年龄段分层,随机抽样选取155例非RLS人群作为对照组,比较两组的一般人口学资料(年龄、文化程度、婚姻状况等)、生活习惯(包括体育锻炼情况、烟酒嗜好等)和既往疾病史等.使用SPSS13.0软件进行单因素分析和多因素非条件Logistic逐步回归分析.结果 单因素分析:病例组与对照组帕金森病病史比例比较差异有统计学意义[8.8％(13/148)比3.2％(5/155)](P＜ 0.05),而吸烟、饮酒、体育锻炼、糖尿病病史、周围神经病病史等既往疾病史在两组间比较差异无统计学意义(P＞0.05).病例组血肌酐水平明显高于对照组[(103.92±32.07)μmol/L比(85.35±36.14)μmol/L],差异有统计学意义(P=0.000),而收缩压、舒张压、血红蛋白、空腹血糖在两组间比较差异无统计学意义(P＞0.05).多因素分析:在调整了可能的影响因素后,既往帕金森病病史、周围神经病病史、血肌酐水平是老年男性RLS的独立危险因素,其OR值(95％ CI)分别为5.68(1.046 ～ 30.846)、4.13(1.109 ～ 15.368)、1.02(1.014～ 1.036).结论 既往帕金森病、周围神经病病史和血肌酐水平是老年男性RLS的独立危险因素.     

社区中老年人群代谢综合征与颈动脉粥样硬化的关系

目的 探讨代谢综合征(MS)与颈动脉粥样硬化的关系,初步了解不同诊断标准的预测效果.方法 于2008年对北京市两组中老年社区人群进行横断面调查,纳入分析者共1266人(男性598人,女性668人),年龄45～69岁.分别采用国际糖尿病联盟(IDF)、美国国家胆固醇教育计划成年人治疗组报告Ⅲ修订版(ATPⅢ修订版)和2007年公布的中国成人血脂异常防治指南("指南")标准诊断MS.结果 IDF、ATPⅢ修订版和"指南"定义的MS患病率分别为39.0%、43.3%和30.9%.三种标准两两之间一致性测量Kappa系数分别为0.911、0.719和0.730.调整了年龄、性别、LDL-C、吸烟、饮酒后,三种定义的MS组CCA-IMT均显著高于非MS组(P＜0.001).调整上述变量后,三种定义的MS均显著增加颈动脉内中膜斑块检出的危险性,OR值分别为1.499(95%CI:1.157～1.942)、1.696(95%CI:1.314～2.189)、1.763(95%CO:1.344～2.312).结论 三种标准定义的MS在吸烟、LDL-C等传统心血管病危险因素以外仍对颈动脉粥样硬化有独立预测作用,不同标准定义的MS与斑块检出风险关联强度可能存在性别差异.     

Prevalence of sexualized violence among women. A population-based study in a primary healthcare district

In order to estimate the prevalence of sexual and physical abuse, postal questionnaires were sent to a random sample of 251 adult women in a primary care district. Three yes/no-questions were asked on these topics, and a fourth inquired into effects on health. Space was left for open-ended answers in which yes-responders were invited to write about their experiences. A total of 175 women (70%) answered, and 25 (14%) of these reported abuse. Nine (5%) had experienced women battering. Thirteen (7.5%) reported sexual abuse as an adult, and 12 (7%) as a child. Many told their stories. Methodological shortcomings in this study might explain why the rates are somewhat lower than in other investigations. However, our figures verified that abuse of women is a common social phenomenon. They also confirmed abuse as a major health problem for women. One-third of respondents explicitly reported effects on health. Others, though negating such effects, described them in written narratives. In order to study this contradiction, in-depth interviews with abused women are recommended.     

Prevalence of infertility in rural areas of Kafr El-Sheikh-Egypt: a community-based study

The current study was carried out in Desok district-Kafr El Sheikh province, to measure the prevalence of primary and secondary infertility among rural women and to study some risk factors as well. The study included 1125 married women between 15-49 years. The results of the study showed that; 7.9% reported secondary infertility 2.5% experienced primary infertility, the prevalence of primary infertility is higher among women under 30 years than older ages, and secondary infertility increases with advance in age. Both types of infertility were higher among women married under the age of 16 or above 30 years. There was an insignificant difference between fertile group and infertile groups regarding age at menarche. Irregular menses was significantly higher among infertile groups compared to fertile group. Secondary infertility group had significant higher abortion and difficult labor than fertile group. There was an insignificant difference between the study groups regarding illiteracy rate. Chronic illnesses of women as well as husbands were significantly more reported among women with secondary infertility. In conclusion, the overall prevalence of infertility is 10.4 %.     

天津市成年居民血脂异常流行特征及影响因素分析

目的 了解天津市成年居民血脂异常流行特征及其影响因素,为血脂异常的预防控制提供参考依据。方法 于2012年1-12月采用分层随机抽样方法对在天津市抽取的8968名≥18周岁成年居民进行体格检查和实验室检测。结果 天津市成年居民血脂异常患病率为28.88%,标化患病率为26.70%;男性血脂异常患病率为34.63%,高于女性的19.98%(χ²=223.5,P=0.000);18~29、30~39、40~49、50~59、60~69和≥70岁成年居民血脂异常患病率分别为17.55%、24.49%、31.33%、37.40%、32.35%和28.36%,血脂异常患病率随着年龄增加先增高后降低(χ²_趋势=105.4,P=0.000);天津市成年居民甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)分别为(1.53±1.23)、(4.91±1.10)、(1.43±0.37)和(2.86±0.80)mmol/L;天津市成年居民高TG血症、高TC血症、高LDL-C血症和低HDL-C血症患病率分别为15.16%、8.95%、6.50%和12.61%,标化患病率分别为14.05%、7.42%、5.36%和12.65%。多因素非条件logistic回归分析结果显示,年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民血脂异常和高TG血症的危险因素,女性和体重过轻是天津市成年居民血脂异常和高TG血症的保护因素;女性、年龄≥30岁、超重、肥胖、高血压、糖尿病和高尿酸血症是天津市成年居民高TC血症的危险因素;女性、年龄≥40岁、超重、肥胖和高血压是天津市成年居民高LDL-C血症的危险因素;超重、肥胖、糖尿病和高尿酸血症是天津市成年居民低HDL-C血症的危险因素,女性和体重过轻是天津市成年居民低HDL-C血症的保护因素。结论 天津市成年居民血脂异常患病率较低,但性别、年龄差异较大;性别、年龄、体质指数(BMI)、血压、血糖和血尿酸是天津市成年居民血脂异常的主要影响因素。     

Prevalence of metabolic syndrome risk factors among young adult Asian Indians

Metabolic syndrome has a high prevalence within the U.S population. Asian Indians have a greater prevalence of the chronic diseases associated with this syndrome compared to Caucasians. This study aimed to determine the prevalence of risk factors of metabolic syndrome in young adult Asian Indians. Behavioral risk factors, dietary intake, and anthropometric measurements were assessed on all study participants (n = 50). The mean BMI was 23.2 and 20.4, waist circumference was 87 and 79 cm, and percent body fat was 16 and 26% for males and females, respectively. Macronutrient contributions to the total energy intake were: carbohydrate 55% for males and females, protein 14 and 12% for males and females respectively, and total fat 31 and 33% for males and females, respectively. Using the definition of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III, ATP III), these Asian Indians did not appear to be at high risk for developing metabolic syndrome. However, using the newly proposed recommendations for Asian Indians, the results suggest that this group may be at risk for developing metabolic syndrome.     

Prevalence of vitamin D deficiency among adult population of Isfahan City, Iran

Determination of vitamin D status in different age-groups in a community and in different climates of a country is necessary and has important implications for general health. The study was conducted to determine the prevalence of vitamin D deficiency among the adult population of Isfahan, a centrally-located city in Iran. In this cross-sectional study, 1,111 healthy people-243 men and 868 women--aged 41.4 (mean 14 and range 20-80) years, who attended a single-consultation outpatient clinic, were selected. Serum 25-hydroxy vitamin D (25-OHD), parathyroid hormone (PTH), calcium and phosphorus concentrations were measured. Mild, moderate and severe vitamin D deficiencies were defined as 25-OHD values of 20-30 ng/mL, 10-20 ng/mL, and < 10 ng/mL respectively. The median (range) concentrations of 25-OHD were 21 (4.0-105.0) ng/mL in males and 18 (1.5-117) ng/mL in females (p = 0.05). The prevalence of mild, moderate and severe vitamin D deficiencies among the adult population was 19.6%, 23.9%, and 26.9% respectively. Vitamin D deficiency was more prevalent among women (p = 0.001) and younger age-group (p = 0.001). Medians of 25-OHD in spring-summer and autumn-winter were 21 ng/mL and 18 ng/mL respectively (p = 0.005). The prevalence of severe vitamin D deficiency was higher in autumn-winter than in spring-summer (odds ratio = 1.6, 95% confidence interval 1.2-2.2, p = 0.001). The prevalence of vitamin D deficiency was high in a sunny city--Isfahan--especially among women and younger population. The high prevalence of vitamin D deficiency in this city emphasizes the necessity of vitamin D supplementation as more exposure to sun is limited due to the type of clothing required by current law.     

江西省成年居民代谢综合征患病及影响因素分析

目的 了解江西省成年居民代谢综合征（MS）患病现状及其影响因素,为采取相应的干预措施提供参考依据。方法 于2013年7-10月采取多阶段分层整群随机抽样方法在江西省10个疾病监测点抽取5 959名≥18周岁成年居民进行问卷调查、体格检查和实验室检测。结果 江西省成年居民MS患病率为11.71%,标化患病率为9.95%;其中,MS各组分指标超重或肥胖、高血糖、高血压和血脂紊乱的检出率分别为28.28%、22.59%、27.79%和25.57%;多因素非条件logistic回归分析结果显示,年龄≥45岁、婚姻状况为已婚/同居/分居/离异/丧偶和静态行为时间≥3 h/d是江西省成年居民MS患病的危险因素,女性是江西省成年居民MS患病的保护因素。结论 江西省成年居民MS患病率较高,性别、年龄、婚姻状况和静态行为时间是江西省成年居民MS患病的主要影响因素。     

Prevalence of antibodies against hantaviruses among the adult population of the Czech Republic

At least three hantavirus genospecies are circulating among wild rodents in Europe: Puumala, Dobrava and Tula, the two first being of clinical significance for humans as possible causative agents of haemorrhagic fever with renal syndrome. As many as 710 adult individuals randomly selected from 12 regions of the Czech Republic were screened for the presence of antibodies against hantaviruses. Commercial sets with Hantaan and Puumala antigens were used for this purpose. Five subjects showed IgG reactivity to Hantaan-like virus (Dobrava) and one subject tested positive for both IgG and IgM antibodies. Two other subjects showed IgM reactivity alone. This means that as many as seven (1.0%) subjects showed reactivity to Hantaan antigen. Eight subjects showed IgG reactivity to Puumala antigen, none of them being IgM positive. Two other subjects were IgM positive only. Altogether ten (1.4%) subjects were reactive to Puumala antigen. Three subjects showed reactivity to both of the antigens tested.