La construcción del diagnóstico / The construction of the diagnosis / La construction du diagnostic / A construção do diagnóstico

Este trabajo, que gira entorno a la consulta por una joven de 14 años, permite desplegar algunas ideas acerca del diagnóstico en psicoanálisis. Se sostiene en una palabra clave: la construcción. Construir un diagnóstico habla de un recorrido singular que lleva tiempo y en la especificidad de la clínica con adolescentes pone en juego múltiples transferencias. Por lo tanto, diagnosticar para un psicoanalista no consiste en subsumir un ejemplar a una clase nosológica sino delinear un trayecto: el trayecto de alguien frente a sus circunstancias AU

This work revolves around the consultation of a 14-year-old girl, allowing us to display some ideas about diagnosis in psychoanalysis. It is based on a key word: construction. Building a diagnosis speaks of a unique journey that takes time and in the specificity of the clinic with adolescents, multiple transfers come into play.Therefore, diagnosing for a psychoanalyst does not consist of subsuming a specimen to a nosological class but rather outlining a path: someone's path in the face of their circumstances AU

Ce travail, qui s'articule autour d'une consultationd'une jeune fille de 14 ans, permet de développer quelques idées sur le diagnosticen psychanalyse. Il repose sur un mot clé: construction. Construire un diagnostic parle d'un parcours unique qui prend du temps et dans la spécificité de la clinique auprès des adolescents, de multiples transferts entrent en jeu.Ainsi, diagnostiquer pour un psychanalyste ne consiste pas à subsumer un spécimen à une classe nosologique mais plutôt à tracer un chemin: le chemin de quelqu'un face à sa situation AU

Este trabalho, que gira em torno da consulta de uma menina de 14 anos, permite-nos desdobrar algumas ideias sobre o diagnóstico em psicanálise. Baseia-se numa palavra-chave: construção. Construir um diagnóstico fala de um percurso único que leva tempo e na especificidade da clínica com adolescentes coloca em jogo múltiplas transferências.Portanto, diagnosticar para um psicanalista não consiste em subsumir um exemplar a uma classe nosológica, mas sim delinear um caminho: o caminho de alguém diante de suas circunstancias AU

Mediating effect of lifestyle on the relationship between family history and cardiovascular disease / 公共卫生与预防医学

Objective To evaluate the mediating effect of lifestyles on the association between family history and cardiovascular disease (CVD). Methods This study was based on the "Early Screening and Comprehensive Intervention of High-risk Populations of Cardiovascular Disease Project". The data were collected from 6 project sites in Hubei Province. Logistic regression analysis was used to investigate the impact of family history and lifestyle on CVD, and the relationship between family history and lifestyle. Mediation analysis was used to evaluate the mediating effect of lifestyle on the association between family history and CVD. Results A total of 5 871 subjects were included in the study from 2015 to 2016, of whom 500 (8.52%) developed CVD and 484 had family history of CVD. The risk of developing CVD was significantly increased in participants with family history of disease (OR = 1.458, P = 0.014) and in those with high level of physical activity (OR = 1.081, P = 0.026). The increase of leisure physical activity time showed a protective effect on developing CVD (OR = 0.977, P < 0.001). Participants with family history significantly increased leisure physical activity (OR = 2.085, P < 0.001), and were less likely to choose occupations with high levels of physical activity (OR = 0.524, P < 0.001). The results of mediation analysis showed that leisure physical activity and occupational physical activity mediated the relationship between family history and CVD, and the β value of the mediating effects were -0.004 (P = 0.010) and 0.002 (P = 0.045), respectively. The β value of the direct effect of family history on CVD was 0.033 (P < 0.05). Conclusion Leisure physical activity and occupational physical activity might mediate the relationship between family history and CVD. People with family history would reduce the risk of developing CVD by increasing leisure physical activity time and choosing occupations with low levels of physical activity.

The acute coronary syndrome risk in medically managed subjects with type 2 diabetes mellitus – Is the ASCVD risk score failing here? / Journal of the ASEAN Federation of Endocrine Societies

Objectives@#Type 2 Diabetics have elevated risk for acute coronary syndrome (ACS). The current management algorithm focuses on atherosclerotic cardiovascular (ASCVD) risk score to stratify this risk. However, in medically managed subjects, this algorithm may not be accurate. This study compares the ASCVD risk score in an Indian population with T2DM under medical supervision and the actual incidence of ACS. It also compared the ASCVD risk scores in cases with T2DM who developed ACS to controls and tried to estimate whether the ASCVD risk score is different in the two subsets, evaluating the utility of the ASCVD risk score in predicting ACS.@*Methodology@#This is an electronic medical record (EMR) based case-control study. Only records of subjects with T2DM where details of age, sex, body mass index, blood pressure, duration of diabetes, family history of ACS, lipid profile, renal and liver function tests were included. The incidence of ACS was calculated in the selected records, and the records of subjects with ACS were compared with age and sex-matched subjects without ACS. Data are summarized as median and interquartile range (IQR). Wilcoxon rank-sum test was used for checking differences in continuous variables and Pearson’s Chi-squared test for categorical data. Univariate and multivariate logistic regression analyses were used to check the effect of ASCVD scores and other variables on the occurrence of ACS. Statistical data analyses were performed using JASP, version 0.16.4 (JASP Team [2022]) for MS Windows. @*Results@#Of the 1226 EMRs included in the analysis, 207 had ACS. The actual incidence of ACS was 16.85% in 6 years, higher than the mean predicted 10-year incidence of 14.56 percent (p <0.05). The cases were age and sex-matched with controls and the ASCVD incidence was estimated in the two groups. The mean ASCVD score in the cases was 14.565 ± 8.709 (Min: 1.5, Max: 38.3) and controls 13.114 ± 8.247 (Min: 1.4, Max: 45). The chance of development of ACS increases with elevated systolic blood pressure (per mmHg rise OR: 1.04, 95% CI: 1.03, 1.06; p <0.001), positive family history (OR: 5.70, 95% CI: 3.41, 9.77; p <0.001), statin use (OR: 2.26, 95% CI: 1.46, 3.52; p <0.001), and longer duration of diabetes (for every year increase OR: 1.19, 95% CI: 1.13, 1.25; p <0.001)@*Conclusion@#The ASCVD risk score underestimates the ACS risk in subjects with T2DM under medical supervision and may not differ in those who developed and did not develop ACS. We also conclude that factors like a negative family history (30% less risk), longer duration of diabetes, and higher SBP are relevant in those who developed ACS.

Epidemiological characteristics and trend of HBV-DNA changes in patients with hepatitis B and liver cancer in Nantong region / 公共卫生与预防医学

Objective Based on the epidemic situation of hepatitis B and liver cancer patients in Nantong from 2019 to 2022, to analyze the trend of hepatitis B virus DNA (HBV-DNA) changes and provide theoretical basis for the prevention and treatment of hepatitis B and liver cancer. Methods The data of patients with hepatitis B and liver cancer in Nantong Cancer Hospital were collected, and the general data, the time of infection with hepatitis B and the results of quantitative HBV-DNA test were statistically analyzed. Results A total of 487 patients with hepatitis B and liver cancer were collected, including 395 males and 92 females. Among them, patients aged 51-60 were the most common, accounting for 28.34%, followed by those aged 41-50 and 61-70, accounting for 23.00% and 21.56% respectively. In addition to 84 patients with unknown infection time, most of the patients with hepatitis B infection time distributed in 11 to 20 years, followed by 21 to 30 years and 1 to 10 years. Except for 126 patients with unknown levels of HBV DNA, the positive rate of HBV DNA in 361 patients was 64.82%. Between 2019 and 2022, except for patients with unknown levels of HBV-DNA, the proportion of patients with HBV-DNA<500 copies/mL showed an upward trend, while the proportion of patients with HBV-DNA (103-106) copies/mL showed a downward trend. Conclusion Sex and the time of infection with hepatitis B are high risk factors for hepatitis B liver cancer. Most patients with liver cancer are positive for HBV-DNA, which needs to be tested regularly to guide antiviral treatment.

Helicobacter pylori y enfermedades alérgicas en niños: un estudio de casos y controles

Introducción: En las dos últimas décadas, se ha explorado el rol de la infección por Helicobacter pylori en la génesis de las enfermedades alérgicas, obteniéndose datos que apoyan la idea de que podría jugar un papel importante en el desarrollo de la alergia. Objetivo: Identificar la asociación entre Helicobacter pylori y enfermedades alérgicas. Materiales y métodos: Estudio de casos y controles prospectivo realizado en la Clínica "Santa Cruz" (Barquisimeto, Estado Lara, Venezuela), entre junio 2022 y junio 2023, donde se compararon 65 niños con enfermedades alérgicas con 130 controles sanos, con edades entre 2 y 15 años, que acudieron a consulta ambulatoria de rutina. Fueron comparadas variables demográficas, parto por cesárea, antecedentes familiares de alergias, tiempo de lactancia materna, exposición al humo de tabaco, mascotas, obesidad, porcentaje de eosinófilos y test de Helicobacter pylori positivo en heces con la presencia de enfermedades alérgicas como variable dependiente. Se utilizó: análisis bivariable y regresión logística binaria. Resultados: Los factores asociados significativamente a enfermedades alérgicas fueron: antecedentes familiares de alergia, tiempo de lactancia materna menor a 12 meses, y test de Helicobacter pylori positivo en heces. Fueron identificados como predictores independientes asociados a enfermedades alérgicas: antecedentes familiares de alergia (RO=2,345; IC95%: 1,245 - 4,416; p = 0,008) y test de Helicobacter pylori positivo en heces (RO=2,072; IC95%: 1,090 - 3,939; p = 0,026). Conclusión: La presencia de antecedentes familiares de alergia y test de Helicobacter pylori positivo en heces fueron identificados como variables independientes asociadas a enfermedades alérgicas.

Introduction: In the last two decades, the role of Helicobacter pylori infection in the genesis of allergic diseases has been explored, showing data supporting the idea that it could play an important role in the development of allergy. Objective: To identify the association between Helicobacter pylori and allergic diseases. Materials and methods: This was a prospective case-control study carried out at the "Santa Cruz" Clinic (Barquisimeto, Lara State, Venezuela), between June 2022 and June 2023, where 65 children with allergic diseases were compared with 130 healthy controls, aged between 2 and 15 years old, who presented for routine outpatient consultation. Demographic variables, cesarean delivery, family history of allergies, breastfeeding time, exposure to tobacco smoke, pets, obesity, percentage of eosinophils and a positive Helicobacter pylori test in feces were compared with the presence of allergic diseases as a dependent variable. Bivariate analysis and binary logistic regression were used. Results: Factors significantly associated with allergic diseases were: family history of allergy, breastfeeding time of less than 12 months, and positive Helicobacter pylori test in feces. The following were identified as independent predictors associated with allergic diseases: family history of allergy (OR=2.345; 95%CI: 1.245 - 4.416; p = 0.008) and positive Helicobacter pylori test in stool (OR=2.072; 95%CI: 1.090 - 3.939; p = 0.026). Conclusions: The presence of a family history of allergy and a positive Helicobacter pylori test in stool were identified as independent variables associated with allergic diseases.

Research progress of familial primary nocturnal enuresis / 中华实用儿科临床杂志

Familial primary nocturnal enuresis (FPNE) is common in clinical practice and has shown an obvious familial aggregation that is associated with genetic factors.It has been found that chromosomes 4, 8, 12, 13 and 22 are related to the inheritance of enuresis. PRDM13 and EDNRB genes are related to the pathogenesis of enuresis, but the specific functions remain unclear.FPNE accounts for a high proportion in patients with refractory enuresis.Compared with other types of primary enuresis, FPNE is not difficult to be diagnosed, as long as the related family members have enuresis, it can be diagnosed as FPNE.Due to treatment difficulties, FPNE easily lasts into adulthood, serving as a type of intractable enuresis.Therefore, early diagnosis and active intervention should be made for children with FPNE.In this review, the epidemiology, pathogenesis, diagnosis and treatment of FPNE were summarized, aiming to provide references for improving the clinical diagnosis and treatment of FPNE.

Identifying barriers to early diagnosis of breast cancer and perception of women in Malwa region of Punjab,India / 《全球健康杂志（英文）》

Objective:The aim of present study is to identify the breast cancer screening barriers among the women with breast cancer of Malwa region of Punjab,India.The study was conducted at three government hospitals representing almost all districts of Malwa region.Methods:The quantitative research design was followed using empirical research methods.Study was carried out by one-to-one interview by the field investigator and research assistant.Total of 363 breast cancer patient has been interviewed through the scheduled questionnaire and results has been recorded for further analysis.In this study,five barriers are described namely as personal barriers,socio-cultural barriers,economic barriers,health-system barriers,and treatment barriers which contains various questions regarding barriers to breast cancer screening.Univariate analysis methods have been used for the analysis to access the socio-demographic profile of women.Data has been obtained with the help of 5-point liker scale.Binary logistic model was chosen.Results:Majority of participants were in the age groups 50-＜60 years(38.6％,140/363)and≥60 years(31.1％,112/363).Majority of these women(47.4％,171/363)were illiterate and most of them were housewives.The major barriers to breast cancer screening faced by most of the women were having no knowledge about screening services(90.9％,329/363),the importance of early diagnosis(90.9％,329/363),different screening methods(95.5％,347/363)and place of availing screening services(91.2％,330/363)misguided belief in God and fate(81.5％,295/363)and preferring duties than taking care of health(70.2％,254/363).Education qualification(odds ratio[OR]0.74,β'=-0.309,t=-5.357,P=0.000)and socioeconomic class(OR 1.43,β'=0.354,t=3.399,P=0.001)were found to be significant determinant of the barriers among women.Conclusion:The survey was conducted in the women between the age 40-60 years and as an outcome,the unawareness about screening services,fatalistic attitude,fear of being diagnosed with the cancer,low per capita income was found out significant factors that restricted the women for early check-up for the breast cancer.

Polymorphism of Gene ACE I/D and Family History of Hypertension as Predisposition of Hypertension

@#Introduction: Hypertension is a polygenic disease that caused 45% of deaths. Various genes have been engaged with the pathogenesis of hypertension. One of these genes affects sodium homeostasis in the kidney, including the ACE I/D gene polymorphism. The present study aimed to investigate the relationship of family history of hypertension and ACE I/D gene polymorphism with the incidence of hypertension in coastal communities of Kendari City. Methods: The study was conducted using a case-control study design. The case group was hypertensive patients based on medical diagnostic by doctors, while the control group was healthy individuals without any records on hypertension. As many as 70 individuals residing in the coastal area of Kendari City were involved as samples of the study. Both case and control groups consisted of 35 individuals. Data collection techniques were carried out experimentally using the PCR-RFLP method. Results: The prevalence of I allele was found in individuals with a family history of hypertension (72.1%) as compared to the D allele (27.9%). The study also found a significant correlation between the family history of hypertension and ACE I/D gene polymorphism (p-value 0.001). However, there was no significant relationship between ACE I/D gene polymorphism and the incidence of hypertension in this population (p-value 0.631). Conclusion: Family history of hypertension was a risk factor for the incidence of hypertension. On the other hand, the polymorphism of ACE I/D gene was a protective factor towards the incidence of hypertension.

Polymorphism of Gene ACE I/D and Family History of Hypertension as the predisposition of Hypertension

@#Introduction: Hypertension is a polygenic disease that caused 45% of deaths. Various genes have been engaged with the pathogenesis of hypertension. One of these genes affects sodium homeostasis in the kidney, including the ACE I/D gene polymorphism. The present study aimed to investigate the relationship of family history of hypertension and ACE I/D gene polymorphism with the incidence of hypertension in coastal communities of Kendari City. Methods: The study was conducted using a case-control study design. The case group was hypertensive patients based on medical diagnostic by doctors, while the control group was healthy individuals without any records on hypertension. As many as 70 individuals residing in the coastal area of Kendari City were involved as samples of the study. Both case and control groups consisted of 35 individuals. Data collection techniques were carried out experimentally using the PCR-RFLP method. Results: The prevalence of I allele was found in individuals with a family history of hypertension (72.1%) as compared to the D allele (27.9%). The study also found a significant correlation between the family history of hypertension and ACE I/D gene polymorphism (p-value 0.001). However, there was no significant relationship between ACE I/D gene polymorphism and the incidence of hypertension in this population (p-value 0.631). Conclusion: Family history of hypertension was a risk factor for the incidence of hypertension. On the other hand, the polymorphism of ACE I/D gene was a protective factor towards the incidence of hypertension.

The influence of family history of diabetes and central obesity on prediabetes and their interaction / 中国糖尿病杂志

Objective To explore the influence of family history of diabetes and central obesity on prediabetes(Pre-DM)and their interaction.Methods Based on the REACTION studyduring August December 2011 in Dalian,2587 individuals aged≥40 with normal blood glucose(BG)were divided into newly diagnosed Pre-DM(n=522)and BG normal group(NC,n=2065)during follow-up.The influence of family history of DM and central obesity on prediabetes and their interaction were analyzed.Results The age,SBP,DBP,BMI,WC,HDL-C,LDL-C,TG,ALT,GGT,FPG,2 hPG,HbA1c,FIns,HOMA-IR,SUA and the incidence of hypertension,fatty liver disease,dyslipidemia,overweight/obesity and central obesity in Pre-DM group were all higher than those in NC group(P＜0.05).Multivariate logistic regression analysis showed that family history of diabetes and central obesity were risk factors for Pre-DM.After adjustment,no significant multiplicative interaction was shown between diabetes family history and central obesity on the risk of Pre-DM(P=0.764).Quantitative analysis of interaction showed that RERI=0.110,S=1.112 and AP=0.053,suggesting that DM family history and central obesity have no significant additive interaction on the risk of Pre-DM.Conclusion The family history of DM and central obesity are both associated with the occurrence of Pre-DM,but there is no significant interaction.

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors / Hiper-homocisteinemia como fator de risco independente para doença coronariana: comparação com fatores de risco convencionais

The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor [...].

O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui [...].

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors / Hiper-homocisteinemia como fator de risco independente para doença coronariana: comparação com fatores de risco convencionais

Abstract The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

Resumo O presente estudo foi desenhado para avaliar a força da associação da concentração elevada de homocisteína no plasma como um fator de risco para doença cardíaca coronária independente do fator de risco convencional. Foi um estudo de caso-controle realizado no Punjab Institute of Cardiology Lahore. Um total de 210 indivíduos com idade entre 25 e 60 anos, compreendendo 105 pacientes recém-admitidos de CHD como casos e 105 indivíduos saudáveis ​​pareados por idade e sexo sem histórico de CHD como controle, foi recrutado para o estudo. Amostras de sangue em jejum foram obtidas de casos e controles. A homocisteína plasmática foi analisada pelo método de imunoensaio de polarização de fluorescência (FPIA) em analisador de imunoensaio automatizado (Abbott IMX). Colesterol total, triglicerídeos e colesterol HDL foram analisados ​​usando métodos de kit calorimétrico. A concentração de colesterol LDL foi calculada pela fórmula de Friedewald. Os pacientes também foram avaliados para fatores de risco tradicionais, como idade, sexo, história familiar de DCV, hipertensão, tabagismo e atividade física, e foram comparados com indivíduos de controle. Os dados coletados foram inseridos no SPSS versão 24 para análise e interpretação. A média de idade nos grupos controles e experimentais foi de 43,00 ± 8,42 anos e 44,72 ± 8,59 anos com distribuição estatisticamente igual (p-valor = 0,144). A homocisteína plasmática média para os casos foi de 22,33 ± 9,22 µmol / L, enquanto no grupo controle foi de 12,59 ± 3,73 µmol / L. Diferença altamente significativa foi observada entre o nível plasmático médio de homocisteína em casos e controles (p ˂ 0,001). A regressão logística simples indica uma forte associação de doença cardíaca coronária com hiper-homocisteinemia (OR 7,45), que permaneceu significativamente associada com doença cardíaca coronária por multivariada regressão logística (OR 7,10, 95% C1 3,12-12,83, p = 0,000). O presente estudo conclui que níveis elevados de homocisteína plasmática são fator de risco independente para doença cardíaca coronária, independentemente dos fatores de risco convencionais, e pode ser usado como um indicador para prever a possibilidade futura de aparecimento de DCV.

A comparative study of sagittal abdominal diameter and other anthropometric indices of obesity in adults with family history of cardiovascular risk factors

Background:Obesity is evolving into a modern day epidemic in India. Visceral Adipose Tissue is the main culprit, being the metabolically active component that is responsible for the cardiovascular risk factors. The day-to-day anthropometric indices fail to take bodycomposition and distribution into account and hence miss a chance at early detection. Family history plays an important role by serving as a genetic link in the transmission of risk factors. There is a need for vigorous screening techniques which are clinically plausible for an early diagnosis of visceral adiposity in individuals predisposed to the numerous risks caused by its accumulation. Sagittal abdominal diameter is a useful tool in measuring the visceral adipose tissue clinically and in the current study; a comparison was done between SAD and already existing anthropometric indices.Methods:The study was done on 223 subjects in Bangalore during the period of November 2015 to May 2017.Among the subjects studied, 54.7% were Male and 45.3% were female. When compared to BMI, WC andWHR, SAD correlated better with total cholesterol, fasting blood sugar, post prandial blood sugar and HbA1c.Results:The mean SAD was more in people with a combined history of DM and HTN than in individuals with history of either DM or HTN alone. Conclusions:We could conclude that Sagittal Abdominal Diameter is comparable to Body Mass Index, but it correlates better with metabolic risk profile of an individual than BMI, WC andWHR.

Breast Cancer Is Significantly Associated with Cancers in The First- and Second-Degree Relatives in Ethnic Mizo-Mongoloid Population, Northeast India

Background: High incidence of breast cancer among the endogamous Mizo-Mongoloid tribe stresses the need to explore the disease pertaining to the family history as well as other risk factors. This study in-vestigates the association of risk factors and inherited diseases with breast cancer.Methodology: The study includes 426 unrelated breast cancer cases and 810 healthy controls of female Mizo ethnicity. Association between reproductive history, lifestyle/ dietary habits, tobacco and alcohol exposures, family history in relation to cancer and inheritable diseases was assessed by univariate lo-gistic regression using Chi-square tests and multivariate analyses using Cox regression. Results: Age at diagnosis was highest between 41 to 50 years. Consumption of fermented pork fat, smoked food and Smoke-less tobacco, lower intake of vegetables/ water, having a first/ or second de-gree relative with cancers and inheritable diseases were found to be the major risk factors. Certain known factors were also acting as confounding factors. Conclusions: The present study reveals that Mizo women with first- and second-degree relatives of breast cancer, various other cancers and inheritable diseases have increased risk of breast cancer. This study also highlights the importance of analysing genetic factors which can aid in early detection of in-herited risk factors.

Association of family history of cardiometabolic diseases (CMDs) and individual health behaviours: Analysis of CARRS study from South Asia

Objectives: Family history is considered as an important predictor of cardiovascular diseases (CVDs) and diabetes. Available research findings suggest that family history of chronic diseases is associated with perceived risk of disease and adoption of healthy behaviours. We examined the association between family history of cardio-metabolic diseases (CMDs) and healthy behaviours among adults without selfreported CMDs. Methods: Cross-sectional data of 12,484 adults, without self-reported CMDs, from the baseline survey of Centre for cArdiometabolic Risk Reduction in South-Asia (CARRS) cohort study were analysed. Results: Family history was positively associated with non-smoking and high fruits & vegetables consumption in the age group of 45e64 years and moderate to high physical activity in the age group _x0001_65 years after adjusting for sex, education, wealth index, city and body mass index. Conclusions: Understanding perceived risks and cultural or psychological factors related to family history through ethnographic studies may deepen understanding of these associations.

The association of family history of herpes zoster and the risk of incident herpes zoster: the SHEZ Study

BACKGROUND@#We investigated whether family histories of herpes zoster (HZ) are associated with the risk of incident HZ in a Japanese population.@*METHODS@#A total of 12,522 Japanese residents aged ≥50 years in Shozu County participated in the baseline survey between December 2008 and November 2009 (the participation rate = 72.3%). They were interviewed at baseline by research physicians regarding the registrants' history of HZ. A self-administered questionnaire survey was conducted to evaluate the potential confounding factors. 10,530 participants without a history of HZ were followed up to ascertain the incidence of HZ during 3-years follow-up until the end of November 2012 with Japanese nationals. We estimated hazard ratios (HRs) of incident HZ according to first-degree family histories using the Cox proportional hazard regression after adjusting for age, sex, and other potential confounding factors.@*RESULTS@#Compared to no HZ history of each family member, a history of brother or sister was associated with a higher risk of incident HZ while histories of father and mother were not. The multivariable HR (95%CI) of incident HZ for a history of brother or sister was 1.67 (1.04-2.69). When comparing to no family histories of all first-degree relatives, the multivariable HRs (95%CIs) were 1.34 (0.77-2.34) for a history of brother or sister alone, but 4.81 (1.78-13.00) for a history of mother plus brother or sister. As for the number of family histories, the multivariable HRs (95%CIs) were 1.08 (0.76-1.54) for one relative (father, mother, or brother or sister) and 2.75 (1.13-6.70) for two or more relatives.@*CONCLUSION@#Family histories of mother plus brother or sister and two or more first-degree relatives were associated with a higher risk of incident HZ.

Pattern of development of Hepatitis ‘C’ and its relation to the family history among the patients in Liver Centre DHQ, Pakistan

The prevalence of hepatitis C is increasing day by day all over the world. Most particularly in Pakistan hundreds of thousands of people are dying by acquisition HCV virus. There is no vaccine available and its treatment is very expensive, we being the under-developed country, solely have an obvious option regarding accurate determination of risk factors in our community to minimize economic strain and scheming for better prevention strategies. The need of the day is to conduct such types of studies on immediate basis. Main objective of this study is to find out associated factors with hepatitis C through surveys and research for hepatitis C patients in Faisalabad. A cross sectional survey from 38 patients was conducted on self-designed questionnaire from one major hospital DHQ of Faisalabad. Further study was to analyse risk factors and its relationship to the family history. The most frequent risk factors among patients with hepatitis C are married patients, illiterate patients, family history of hepatitis, surgical operations and road accidents, patients’ age, patient history of jaundice, and shaving by barber. Married patients and family history of hepatitis are the common factors in both urban and rural population. Risk of hepatitis C is found to be highest in urban Married patients. It is concluded that some risk factors for the transmission of HCV are different in urban and rural areas. Moreover, in Pakistan, this study revealed that the family history of this disease is found to be a vital risk factor. Finally, our study Models can be used for the prediction of pattern of development of hepatitis C in majority of the patients.

Historia familiar de enfermedad tiroidea y riesgo de hipotiroidismo congénito en neonatos con síndrome de Down / Family history of thyroid disease and risk of congenital hypothyroidism in neonates with Down syndrome

Resumen Introducción: La historia familiar de enfermedad tiroidea (HFET) como factor de riesgo para hipotiroidismo congénito (HC), en síndrome de Down (SD) aún no ha sido explorada. Objetivo: Determinar si la HFET está asociada a mayor riesgo de HC en neonatos con SD. Método: Estudio de casos y controles en 220 neonatos con SD. Se compararon las pruebas de función tiroidea (PFT) de 37 con SD e HFET (casos), frente a las PFT de 183 recién nacidos con SD sin HFET (grupo de referencia). Se realizó análisis de regresión logística multivariante y se calculó la razón de momios (RM) y sus respectivos intervalos de confianza del 95 % (IC 95 %). Resultados: Nueve casos HC (4.1 %). El HC mostró asociación con la HFET (RMa = 8.3, IC 95 %: 2.0-34.3), particularmente en los varones (RMa = 9.0, IC 95 %: 1.6-49.6). La ausencia de HFET tuvo una RM de protección para HC (RMa = 0.4, IC 95 %: 0.1-0.8). Conclusiones: La HFET puede es una estrategia fácil y accesible para identificar pacientes con SD con mayor riesgo de HC.

Abstract Introduction: Family history of thyroid disease (FHTD) as risk factor for congenital hypothyroidism (CH) in patients with Down syndrome (DS) has not yet been explored. Objective: To determine whether FHTD is associated with an increased risk for CH in DS. Method: Case-control study in 220 neonates with DS. Thyroid function tests of 37 infants with DS and FHTD (cases) were compared with those of 183 DS newborns without FHTD (reference group). Data were analyzed using multivariate logistic regression analysis and adjusted odds ratios (aORs) with their respective 95 % confidence intervals (CI) were calculated. Results: Nine newborns with DS in our sample had CH (4.1 %). FHTD showed an association with CH in neonates with DS (aOR = 8.3, 95 % CI: 2.0-34.3), particularly in males (aOR = 9.0, 95 % CI: 1.6-49.6). In contrast, newborns with DS without FHTD were less likely to suffer from CH (aOR = 0.4, 95 % CI: 0.1-0.8). Conclusions: FHTD detailed evaluation can be an easy and accessible strategy to identify those newborns with DS at higher risk for CH.

The prevalence of gout and related factors in community population / 中华内分泌代谢杂志

Objective:To explore the prevalence of gout and related factors in community population, thereby provide evidence for comprehensive prevention and control of gout in community.Methods:A stratified multi-stage cluster sampling was used to survey the permanent residents of 20 to 75 years old in the 3 selected streets (towns), univariate analysis was performed using logistic regression by SPSS statistical software.Results:The prevalences of hyperuricemia and gout were 9.82% and 5.75% respectively(male 18.88% and 7.94%, female 3.79% and 4.29%)in Jiading Shanghai. The positive rate of family history was 17.13%, and the relationship between family history and gout was significant( OR=3.140, 95% CI 2.365-4.169, P<0.01). Age( OR=1.034, 95% CI 1.021-1.047), body mass index ( OR=1.102, 95% CI 1.074-1.131), waist-hip ratio ( OR=4.876, 95% CI 1.153-20.622), sleep quality ( OR=1.310, 95% CI 1.159-1.480), other animal meat ( OR=1.117, 95% CI 1.007-1.240), fresh water fish ( OR=1.138, 95% CI 1.005-1.288), and processed meat ( OR=1.145, 95% CI 1.033-1.270) were closely related to gout ( P<0.05 or P<0.01). Sex, alcohol drinking, marine fish, and soybean milk/soymilk were related to gout ( P<0.05 or P<0.01), but showed a protective effect ( OR<1.000). Conclusion:Reducing uric acid production through less consumption of purine-rich food such as animal meat as well as processed meat and weight control would be helpful in preventing gout.