Despite advances in medicine and preventive strategies, fewer than 1 in 5 people with hypertension have the problem under control. This could partly be due to gaps in fully elucidating the etiology of hypertension. Genetics and conventional lifestyle risk factors, such as the lack of exercise, unhealthy diet, excess salt intake, and alcohol consumption, do not fully explain the pathogenesis of hypertension. Thus, it is necessary to revisit other suggested risk factors that have not been paid due attention. One such factor is psychosocial stress. This paper explores the evidence for the association of psychosocial stressors with hypertension and shows that robust evidence supports the role of a chronic stressful environment at work or in marriage, low socioeconomic status, lack of social support, depression, anxiety, post-traumatic stress, childhood psychological trauma, and racial discrimination in the development or progression of hypertension. Furthermore, the potential pathophysiological mechanisms that link psychosocial stress to hypertension are explained to address the ambiguity in this area and set the stage for further research.
Dietary pattern analysis is important complementary approach for identifying associations between diet and chronic disease. A case-control study was conducted in order to examine dietary patterns and the risk of colon cancer in Korea. Data were collected from both 137 cases with either colorectal cancer or large bowl adenomatous polyps and 134 controls regarding social-demographic characteristics and food intake using a semi-quantitative food frequency questionnaire. We conducted factor analysis and identified 6 major dietary patterns: 'Well-being diet' characterized by higher intakes of potatoes, yogurt, soybean paste and vegetables, 'Meat & fish', 'Milk & juice', 'Pork & alcohol', 'Rice & kimchi', and 'Coffee & cake'. We calculated factor scores for each participant and examined the associations between dietary patterns and colon cancer risk. After adjusting for potential confounders, there was a relative risk for colon cancer of 0.16 (95% confidence interval, 0.07 - 0.34) when comparing the highest with the lowest tertile of the 'Well-being' pattern. Significant trends of decreasing risk of colon cancer also emerged with the 'Milk & juice' (OR = 0.40, 95% CI = 0.20 - 0.79). In contrast, inverse associations of the risk were found for 'Pork & alcohol' (OR = 1.92, 95% CI = 0.93 - 3.97), 'Coffee & cake' (OR = 2.18, 95% CI = 1.07 - 4.46). For the 'Meat & fish' pattern, the decreased risk of colon cancer was observed in the second tertile, but not in the highest tertile when comparing to the lowest. The 'Rice & kimchi' pattern had a nonsignificant association with the risk. These data suggest that major dietary patterns derived from the FFQ associated with the risk of colon cancer in Korea. Since foods are not consumed in isolation, dietary pattern research in natural eating behavior may be useful for understanding dietary causes of colon cancer.
Over the past few decades, changes in patterns of behavior (e.g., diet, smoking, alcohol consumption, and physical activity) have led to major changes in health status, characterized by increases in obesity, Type II diabetes mellitus, cardiovascular disease, and some cancers. This epidemiologic transition is largely the result of rapid increases in immigration to developed countries and rural-urban migration within developing countries, which is usually accompanied by environmental and lifestyle changes. In particular, adoption of “Western” dietary patterns, which tend to be high in fat and low in fruits and vegetables, is of concern since diet is a potent contributor to chronic disease risk. However, until recently, the process by which immigrants and rural-urban migrants adopt the dietary practices predominant in their new environments, known as dietary acculturation, has received very little research attention. Dietary acculturation is multidimensional, dynamic, and complex, and varies considerably depending on a variety of personal, cultural, and environmental characteristics. Therefore, to intervene successfully on the negative aspects of dietary acculturation, it is important to understand the process and identify factors that predispose and enable it to occur. The purpose of this article is to provide a practical model for understanding and investigating the effect of dietary acculturation on food and nutrient intake. Thus, this report 1) gives an overview of acculturation, 2) defines dietary acculturation and presents a model for how it occurs, 3) discusses measurement issues around dietary acculturation,4) reviews the literature on dietary acculturation in Korean Americans; 4) suggests a paradigm for acculturation research; and 5) offers some recommendations for future research in this area.
Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.
BACKGROUND/OBJECTIVES: Obesity, which is a known risk factor for many chronic diseases, has also been associated with vitamin D deficiency. This study explored the relationship between serum 25-hydroxy-vitamin D [25(OH)D] concentrations and adiposity measures in a general Korean population using the most recent, nationally representative survey data. SUBJECTS/METHODS: The study sample consisted of 4,771 Korean adults (${\geq}19years$) who participated in the fifth Korean National Health and Nutrition Examination Surveys. Serum 25(OH)D was determined by radioimmunoassay. Body mass index (BMI), waist circumference (WC) and total body fat content were measured as adiposity measurements. Total body fat content was measured by dual-energy X-ray absorptiometry. RESULTS: The serum 25(OH)D level was significantly higher in men than in women. Serum 25(OH)D concentration was positively correlated with energy intake, and it was negatively correlated with total body fat content (P < 0.0001) and percentage body fat (P < 0.0001) after adjustment for age in both sexes, while was inversely correlated with BMI only in women. In multivariable regression analysis, serum 25(OH)D was inversely associated with the total body fat content after adjustment for age, BMI, education, region, smoking, alcohol consumption, physical activity, and energy intake only in men (P = 0.0047). However, the serum 25(OH)D concentration was not associated with WC or BMI, indicators of adiposity after adjustment for potential risk factors. CONCLUSIONS: Serum 25(OH)D concentration was independently associated with the total body fat content in a general Korean population, but it may be not associated with the indicators for estimating adiposity, such as WC or BMI.
This study was performed to determine the prevalence and associated risk factors of osteoarthritis in the elderly using the Korea National Health and Nutrition Examination Survey (2013~2014 KNHANES VI). A total of 2,148 (936 males, 1212 females) elderly participants aged 65 years or older were selected. Prevalence of osteoarthritis was higher in 460 female (80.7%) and 167 rural (29.1%) groups, than in 110 male (19.3%) and 404 urban (70.9%) groups. While the mean values of LDL-cholesterol, triglyceride level, and waist circumference were significantly higher in the osteoarthritis group than the normal group, other parameters including height, HDL-cholesterol, fasting blood glucose, hemoglobin and hematocrit values were not. Quality of life (EQ-5D) was also significantly lower in the osteoarthritis group. The results of logistic regression analysis showed that smoking, alcohol intake, obesity, hypercholesterolemia and energy intakes were significantly different in regards to the prevalence of osteoarthritis. This study suggests that obesity and energy intakes were associated with osteoarthritis, whereas risk factors of chronic disease, such as hypertension, Hypo-high density lipoprotein, hypertrigly-ceridemia, anemia, diabetes, vigorous physical activity, moderate physical activity and walking were not. Long-term prospective study is necessary to investigate the effects of these factors on osteoarthritis.
Recent trends in agricultural globalization have brought on a crisis to our already impoverished Korean farmers. This study was proposed to assist in comparing the health and dietary characteristics of farmer families that have chronic disease patients to farmer families that do not have chronic disease patients. For the study, 1870 families were selected from 9 rural Korean provinces. Trained evaluators interviewed farmer housewives to collect demographic, health behavior, and dietary relative information about family members. Statistical analyses were performed using SAS (ver 8.2). Chi-square tests and General Linear Models were also used. In general, patient family members were older than non-patient family members. For patient families, the mean age was 70.4 for husbands and 64.3 for wives. For non-patient families, the mean age was 64.2 for husbands and 57.3 for wives. Therefore we analyzed the data after we stratified the subjects based on the wife's age of 65. Patient families snacked less and 'dined out' less than non-patient families. However, they consumed cookies more frequently, and milk and fruits less frequently, when compared to non-patient families. There were no significant differences in nutrient supplementation, and/or instant food intake frequencies between patient families and non-patient families. Sixty-two percent of patient family members complained about health problems such arthritis, lumbago, numbness, shoulder pain, dizziness, and others, whereas 52olo of non-patient family members complained about Farmers' syndrome. Husband cigarette smoking was not significantly different among groups. However, the smoking patterns of the wives was significantly higher in patient families. Alcohol consumption was also higher in patient families. In summary, it was determined that rural patient families had poorer dietary behavior and poorer health in general, when compared to non-patient families, and accordingly, diverse community-level health and nutritional support are suggested to solve the farmers' health problems and to improve their quality of life.
Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.
Song, Joon Hyuk;Cheon, Sang Soo;Bae, Myung Hwan;Lee, Jang Hoon;Yang, Dong Heon;Park, Hun Sik;Cho, Yongkeun;Chae, Shung Chull
Journal of Yeungnam Medical Science
/
제31권1호
/
pp.38-42
/
2014
Cardiovascular beriberi is caused by thiamine deficiency and usually presents as high cardiac output failure associated with predominantly right-sided heart failure and rapid recovery after treatment with thiamine. Because of its rarity in developed countries, the diagnosis can often be delayed and missed. We recently experienced a case of cardiovascular beriberi with pulmonary hypertension which successfully treated with thiamine infusion. A 50-year-old man with chronic heavy alcoholics was refered to our department for dyspnea with mental change. Echocardiography showed marked right ventricular (RV) dilatation and flattening of the interventricular septum with a D-shaped deformation of the left ventricle. Moderate tricuspid valve regurgitation was found and estimated RV systolic pressure was 52 mm Hg. Because of his confused mentality and history of chronic alcohol intake, neurological disorder due to thiamine deficiency was suspected and intravenous thiamine was administered and he continuously received a daily dose of 100 mg of thiamine. Follow up echocardiography showed marked reduction of RV dilatation and improvement of a D-shaped deformation of the left ventricle. He finally diagnosed as cardiovascular beriberi on the basis of dramatic response to intravenous thiamine. Thiamine deficiency can cause reversible pulmonary hypertension, and can still be encountered in the clinical setting. Thus high index of suspicion is critically needed for diagnosis.
Background: The problem of cancer, especially lung cancer, is very acute in Bangladesh. The present study was conducted to evaluate the risk of lung cancer among Bangladeshi people based on hereditary, socio-economic and demographic factors. Materials and Methods: This study was carried out in 208 people (patients-104, controls-104) from January 2012 to September 2013 using a structured questionnaire containing details of lung cancer risk factors including smoking, secondhand smoke, tobacco leaf intake, age, gender, family history, chronic lung diseases, radiotherapy in the chest area, diet, obesity, physical activity, alcohol consumption, occupation, education, and income. Descriptive statistics and testing of hypotheses were used for the analysis using SPSS software (version 20). Results: According to this study, lung cancer was more prevalent in males than females. Smoking was the highest risk factor (OR=9.707; RR=3.924; sensitivity=0.8872 and P<0.0001) followed by previous lung disease (asthma, tuberculosis etc.) (OR=7.095; RR=1.508; sensitivity=0.316 and P<0.0001)) for male patients. Highly cooked food (OR=2.485; RR=1.126; sensitivity=0.418 and P=0.004)) and also genetic inheritance (OR=1.93; RR=1.335; sensitivity=0.163 and P=0.138) demonstrated significant correlation with lung cancer as risk factors after these two and alcohol consumption was not prevalent. On the other hand, for female patients, tobacco leaf intake represented the highest risk (OR=2.00; RR=1.429; sensitivity= 0.667 and P=0.5603) while genetic inheritance and highly cooked food also correlate with lung cancer but not so significantly. Socioeconomic status and education level also play important roles in causing lung cancer. Some 78.5% male and 83.3% of female cancer patients were rural residents, while 58.2% lived at the margin or below the poverty line. Most male (39.8%) and female (50.0%) patients had completed only primary level education, and 27.6% male and 33.3% female patients were illiterate. Smoking was found to be more prevalent among the less educated persons. Conclusions: The results obtained in this study indicate the importance of creating awareness about lung cancer risk factors among Bangladeshi people and making appropriate access to health services for the illiterate, poor, rural people.
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