Combined arteriosclerotic assessment of ankle-brachial index and maximum intima-media thickness via CCTA is useful for predicting coronary artery stenosis in patients with type 2 diabetes.

AIMS: Patients with diabetes mellitus (DM) are likely to develop asymptomatic myocardial infarction as a complication. However, coronary artery lesions are difficult to assess in internal medicine. This study aimed to develop a prediction formula for coronary artery stenosis, as determined by coronary computed tomographic angiography (CCTA), by analyzing risk factors in patients with type 2 DM. METHODS: A prediction formula was developed based on a multivariate analysis of common factors in patients with ⩾50% coronary artery stenosis in a cohort of 327 patients with type 2 DM who underwent CCTA between 2007 and 2009, and cutoff values were calculated (derivation study). The validity of the optimal cutoff value was confirmed in a separate cohort of 317 patients with type 2 DM who underwent CCTA between 2010 and 2011 (validation study). RESULTS: In the derivation study, five predictive factors (presence/absence of hypertension, estimated glomerular filtration rate, maximum intima-media thickness [max-IMT], ankle-brachial index [ABI], and use/nonuse of diabetic medication) were used to develop a prediction formula. In the validation study, positive predictive value (PPV) and negative predictive value (NPV) of the cutoff value derived from the prediction formula were 53% and 73%, respectively. CONCLUSIONS: We developed a novel formula to predict coronary artery stenosis using five predictive factors. This formula is useful for determining whether computed tomography (CT) examination is necessary, even in clinical settings without CCTA equipment. Early detection of coronary artery stenosis in patients with DM may also lead to better health outcomes.

[Relationship between Explanation from Guardians and Preventive Behaviors against Uterine Cervical Cancer at the Time of Inoculation of HPV Vaccine].

OBJECTIVES: The purpose of this study is to clarify whether the explanation received from the guardian at the time of inoculation of a HPV vaccine is related to preventive behaviors against uterine cervical cancer among junior high school girls. The preventive behaviors were set as "wishing to receive the HPV vaccination" and "considering on sexual behaviors (dating, kissing, sexual relations)." METHODS: An anonymous self-administered questionnaire survey was performed on 206 second-year junior high school girls who were candidates for the inoculation of the HPV vaccine in the previous year. We considered that a subject received an explanation on HPV vaccination if she received explanations on this topic, such as "an HPV vaccine prevents uterine cancer." We considered that a subject received an explanation on pubertal events if she received explanations on this topic, such as "the importance of a life." Including these two variables among the independent variables, multiple logistic regression analysis was performed. RESULTS: The knowledge on uterine cancer was promoted when the subjects received explanations about the HPV vaccination. Many subjects received explanations on pubertal events by receiving explanations on HPV vaccination. The guardian's explanation about HPV vaccination was one of the factors related to "wishing to receive the HPV vaccination" and "considering on sexual behaviors." CONCLUSION: It is important for guardians to explain to their children about HPV vaccination without hesitation at the time of the vaccination.