Epidemiology of opium use in the general population

AIMS: To evaluate the prevalence of opium use in the Fars province, Iran. METHOD: A household survey of a representative sample of 3840 people aged 15 years and over. Researchers assessed opium use disorders using a semistructured interview and the Research Version of the Structured Clinical Interview for DSM-IV Axis I, during 2003. RESULTS: Mean age of the sample was 33.9 years (SD = 15). Of the participants, 689 (17.9%) admitted use of opium one or more times during their lives (28.4% of men and 7.4% of women). Three hundred thirty-nine (8.8%) were current opium users (14.3% of men and 3.3% of women). Opium ever-use and current-use were not functions of marital status. Both opium ever-use and current-use are found across the educational, occupational and income spectrums. Both peaked in the 40-49 age category, suggesting that first use usually occurs before 40 years of age and that current use extends across all age groups. CONCLUSION: Men are at greater risk than women. This report provides useful information for health planning. Prevention programs should focus on those under 40 years of age, and treatment is required across all age groups.     

Epidemiology of adult congenital heart disease among the general population in Kuwait

BackgroundAdult congenital heart disease (ACHD) is a highly underrepresented entity in medical literature, especially in the middle‐eastern region.HypothesisThis study is the first to assess the prevalence of adult congenital heart disease among the population of Kuwait.MethodsAfter a retrospective register review of patients in Kuwait being followed up in the chest diseases hospital was conducted, patients who fit the inclusion criteria were enrolled in the study. Using the American College of Cardiology Task Force 1 of the 32nd Bethesda conference classification of the severity of ACHD, the patients were classified into those with simple, moderate, and complex congenital heart diseases. The age and gender of the patients, as well as the type repair performed, and the residual cardiac findings were recorded to assess the association between the complexity and residuals. Associations were assessed using STATA 15.ResultsA total of 611 patients were evaluated over a period of 18 months. The youngest participant was 20 years of age, and the oldest participant was 88 years old. Male participants with moderate congenital heart disease class were more common in our study population. Patients with complex congenital heart disease have more residual cardiac lesion than the moderate or simple groups. Almost (70%) of patients with complex cardiac anomalies have undergone either partial or complete repair. The most prevalent cardiac defect was atrial septal defect (21.5%). Tetralogy of Fallot was the most prevalent defect in the moderate group, representing (13%) of the group. The most prevalent anomaly in the complex group was double outlet right ventricle (DORV) representing (15.38%).ConclusionAdult Congenital heart disease is a growing entity of heart disease due to advanced repair techniques. This population requires registries to document cases and assign specialists for the management and care of this special group of patients.Highlights

• First database of adult congenital heart disease in Kuwait.
• The most prevalent heart defect was ASD in Kuwait.
• TOF was the most prevalent defect in the moderate group; and DORV was the most prevalent in the complex group.
• Patients with moderate ACHD tended to have a more complete repair than those in the complex group.

     

Prevalence of non-ulcer dyspepsia in the Japanese population

BACKGROUND: Non-ulcer dyspepsia (NUD) is one of the most frequently encountered disorders in general practice in Western countries. The prevalence of this disorder in the Japanese, however, has not been fully investigated. This study is designed to clarify the characteristics and prevalence of dyspepsia in the Japanese. METHODS: The subjects were 1139 people who visited our institutes for their annual medical check up for gastric cancers. After routine medical examination, all subjects were asked standardized questions in order to check for the presence of any symptoms suggesting dyspepsia. RESULTS: The results of the study showed that dysmotility-like dyspepsia, characterized by the presence of nausea, fullness and early satiety, is the most frequently observed dyspepsia in Japanese and that this type of dyspepsia decreases with age. Ulcer-like dyspepsia, which is the major type of dyspepsia in Western countries, is the least frequently experienced dyspepsia in the Japanese. CONCLUSIONS: This study clarified that NUD is also one of the most prevalent disorders in the Japanese, although its characteristics may be somewhat different from those in Western countries.     

Fluctuation in dyspepsia subgroups over time. A three-year follow-up of patients consulting general practice for dyspepsia

BACKGROUND: General practitioners base their treatment and investigation on the symptoms presented by the patients. Subgroups of dyspepsia have been defined in order to guide management. AIM: To study prospectively changes over time in the presentation of dyspepsia according to different subtypes in a general practitioner population. SUBJECTS: Patients consulting the general practitioner because of dyspeptic complaints. METHODS: A random sample of general practitioner patients consulting with different dyspepsia subtypes (ulcer-like, reflux-like, dysmotility-like, uncharacteristic and relapsing dyspepsia) were studied three years after the initial consultation by postal questionnaires to the general practitioners (obtaining information from the patient records) and to the patients (obtaining self-reported symptoms during twelve months). The subtype of dyspepsia at baseline was compared to the subtype in the patient questionnaire. RESULTS: Between 20 and 34% of the patients reported no dyspepsia after three years, with so significant difference between the subtypes. Changes from one subtype to another were common, ulcer-like and reflux-like often changed into dysmotility-like dyspepsia. Dysmotility-like dyspepsia was significantly more stable over time. Patients with more than one episode of dyspepsia changed subtype significantly less. CONCLUSIONS: Most patients who presented with dyspepsia to the general practitioner still reported symptoms three years later. Few patients with dysmotility-like dyspepsia changed subtype over time, whereas changes from one subtype to another were common in other subtypes. This implies that dyspeptic patients could end up having dysmotility-like complaints possibly due to the lack of effective treatment for this condition, compared to the other dyspepsia subtypes.     

Epidemiology of functional dyspepsia: a global perspective

Dyspepsia refers to group of upper gastrointestinal symptoms that occur commonly in adults. Dyspepsia is known to result from organic causes, but the majority of patients suffer from non-ulcer or functional dyspepsia. Epidemiological data from population-based studies of various geographical locations have been reviewed, as they provide more realistic information. Population-based studies on true functional dyspepsia (FD) are few, due to the logistic difficulties of excluding structural disease in large numbers of people. Globally, the prevalence of uninvestigated dyspepsia (UD) varies between 7%-45%, depending on definition used and geographical location, whilst the prevalence of FD has been noted to vary between 11%-29.2%. Risk factors for FD have been shown to include females and underlying psychological disturbances, whilst environmental/ lifestyle habits such as poor socio-economic status, smoking, increased caffeine intake and ingestion of non-steroidal anti-inflammatory drugs appear to be more relevant to UD. It is clear that dyspepsia and FD in particular are common conditions globally, affecting most populations, regardless of location.     

Dyspepsia in the general population in Jordan.

OBJECTIVE: To assess the prevalence of dyspeptic symptoms in the general population of Jordan. METHODS: We selected families of final year students at the two medical schools in Jordan to represent the general population. The students were instructed to complete questionnaires for all their family members and all members of the close family above the age of 15 years living in the area. The questionnaire enquired about dyspeptic symptoms in the previous 12 months. Information about any chronic disease, medications used frequently, previous operations and cigarette smoking was obtained. RESULTS: Of 2254 completed questionnaires, dyspeptic symptoms were reported in 1354 (60.1%) during the previous 12 months. Heartburn was present in 1111 (49.3%), abdominal distension in 1224 (54.3%), recurrent abdominal pain with ulcer-like characters in 450 (20%), discomfort following meals in 316 (14%), symptoms related to fatty foods in 359 (15.9%) and symptoms related to ingestion of lactose-containing foods in 96 (4.3%). CONCLUSION: Dyspeptic symptoms are highly prevalent in Jordan. This may have an impact on the economy and health resources.     

Epidemiology of non-ulcer dyspepsia (NUD) in Japan]

The purpose of this study is to investigate the incidence of NUD in Japan and to describe the clinical presentation of NUD. The population of this study consisted of the patients initially visited to our gastroenterology clinic during the period of one year from Feb. 1990 to Jan. 1991. Out of the total population, 106 patients with dyspepsia were suspected of NUD according to the definition of AGA, and have received the endoscopy and ultrasonography to find the existence of organic disease. While 50 cases presented organic diseases (19 peptic ulcers, 16 gastritis, 7 carcinoma, 4 gall stone, 4 esophageal disease), 56 cases were with no organic diseases and were regarded as NUD. NUD was more common in younger generation and was especially so in women under 40 years old. There was no significant difference in symptoms between NUD and organic diseases. On the other hand, peptic ulcer disease was frequently associated with sever epigastralgia, and smoking habit as a external factor, while abdominal fullness was predominant feature observed in NUD.     

Epidemiology of venous insufficiency in an occupational population.

AIM: A cross sectional study of the prevalence and risk factors of chronic venous insufficiency (CVI) in a South European occupational population was performed. METHODS: Over a 7-month period a questionnaire (CVI symptoms, general data and life style habits) was administrated to 1604 consecutive females (73.3%) and 586 consecutive males (26.7%). An oriented clinical examination was then performed. Subjects were classified into 4 groups: asymptomatic, light, moderate and severe CVI. Univariate and multivariate analysis were used. RESULTS: Mean age 38.8+/-11.6 years (range 15-65). The prevalence of CVI all classes confounded was 51.4% (62.3% in women and 21.8% in men); the prevalence of moderate and severe CVI was 10.4% (12.1% in female and 6.3% in male). Age (Odds Ratio (OR): 1.93, 95% confidence interval (CI): 1.55-3.53), female sex (OR: 2.34, 95% CI: 1.62-2.30), obesity (kg/m(2)) (OR:1.11, 95% CI: 1.07-1.15) and familial history of CVI (OR: 2.80, 95% CI: 2.02-3.89) were risks factors of moderate and severe CVI. The comparison extended to the whole group of CVI added other risk factors: history of leg injury, pregnancy; a sitting posture at work. Unexpectedly smoking had a protective effect but only in the female group for the last one. CONCLUSION: CVI is an important medical problem concern in this population. Some of the risk factors like obesity and standing position at work may benefit from preventive measures.     

Maximal airway narrowing in a general population.

To characterize airway responses in a population sample, respiratory symptoms, smoking habits, and changes in FEV1 (delta FEV1) to inhaled methacholine (maximal cumulative dose of 196 mumol or maximal decrease in FEV1 of 50%) were recorded in 201 subjects. From each dose-response curve the plateau (delta FEV1 less than or equal to 5% over two or more dose steps) response, the maximal response (average of responses on the plateau or maximal delta FEV1 when no plateau was present), slope, and PD20 (dose required to cause delta FEV1 greater than 20%) were derived. The pattern of dose-response curves was a continuous change from being flat (maximal delta FEV1 less than or equal to 5%), becoming steeper with a plateau that occurred at a greater change in FEV1 as the curves were shifted more to the left, to being the steepest without a plateau response. Maximal delta FEV1 was significantly related to the PD20 (r = -0.64, p less than 0.001) and the slope (r = 0.63, p less than 0.001). A history of doctor-diagnosed asthma or wheeze in the last 12 months was related to the level of the maximal delta FEV1 and to PD20. Likelihood ratios [LR = sensitivity/(1-specificity)] for asthma or wheeze were higher for a maximal delta FEV1 of 50% plus a PD20 of 4 mumol (LR = 6.5) or 1 mumol (LR = 7) than for either alone. Subjects without reported asthma or wheeze more often had a plateau on the dose-response curve (76%) than those with a positive history (49%, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)     

在就诊患者和健康体检者中筛检人胃螺杆菌

目的：通过几种不同的检查方法调查人胃螺杆菌在人群中的感染情况及在慢性胃炎中的致病作用。方法：３８０例行消化道症状的就诊患者和４３２名健康体检者的胃粘膜活检标本分别行涂片、尿素酶试验、１４Ｃ－尿素呼吸试验和组织学检查。结果：人胃螺杆菌在上述两类人群中的感染率分别为２．１１％和１．１６％。涂片Ｇｒａｍ染色和切片ＷＳ银染是目前诊断该菌感染较理想的手段，不论有无症状，患者在组织学上均伴有慢性炎症改变，根据形态学特点该菌可大致分为两型，分别与某些动物胃内的螺旋菌相似。结论：人胃螺杆菌在人群中感染率较低，可能是一种源自动物的慢性胃炎相关性病原菌。     

Prevalence of irritable bowel syndrome and functional dyspepsia,overlapping symptoms,and associated factors in a general population of Bangladesh

Background

This community-based survey aimed to find out the prevalence of irritable bowel syndrome (IBS), functional dyspepsia (FD), overlapping symptoms, and associated factors for overlap.

Method

By cluster sampling method, 3,000 (1,523 male) randomly selected adult subjects in the Sylhet district of Bangladesh were interviewed by a questionnaire based on ROME III criteria. Multivariate logistic regression analyses were done to find out the factors for overlap with significance level set at ≤0.05.

Results

The mean age of the study population was 33.9?±?16.4 years. Prevalence of IBS and FD and IBS-FD were 12.9 % (n?=?387), 8.3 % (n?=?249), and 3.5 % (n?=?105), respectively. Approximately 27.1 % of IBS patients and 42.1 % of FD patients had overlapping IBS-FD. The odds ratio for IBS-FD overlap was 6.3 (95 % CI, 4.8–8.4). Mean age (p?=?0.011) and epigastric pain (p?=?0.002) were more in overlap patients than FD alone, whereas epigastric pain syndrome subtype (p?<?0.009) was more prevalent in lone FD subjects. In the multivariate logistic analysis, early satiety (OR, 3.0; 95 % CI, 1.2–7.5; p?=?0.018) and epigastric pain (OR, 14.5; 95 % CI, 5.0–42.1; p?=?0.000) in FD patients appeared as independent risk factors for overlap. Bloating (p?=?0.026), <3 stools per week (p?=?0.050), abdominal pain reduced by defecation (p?=?0.002), abdominal pain severity score (p?=?0.004), and overall symptom frequency score (p?=?0.000) were more in overlap patients than IBS-alone patients. In IBS patients, bloating (OR, 3.6; CI, 2.0–6.5; p?=?0.000) was found as potential symptom associated with IBS-FD overlap.

Conclusion

FD was a less prevalent disorder than IBS in our community, and significant overlap existed between the two disorders. Early satiety, epigastric pain, and bloating were important factors associated with overlap.