Association between evacuation and becoming overweight after the Great East Japan Earthquake: a 7-year follow-up of the Fukushima Health Management Survey.

OBJECTIVES: Disaster evacuation increases the risk of becoming overweight or obese owing to lifestyle changes and psychosocial factors. This study evaluated the effect of evacuation on becoming overweight during a 7-year follow-up among residents of Fukushima Prefecture during the Great East Japan Earthquake. STUDY DESIGN: This was a prospective cohort study. METHODS: We analysed data collected from 18,977 non-overweight Japanese participants who completed the 'Comprehensive Health Checkup Program' and 'Mental Health and Lifestyle Survey', as part of the Fukushima Health Management Survey, between July 2011 and November 2012. An evacuation was defined as the moving out of residents of municipalities designated as an evacuation zone by the government or having a self-reported experience of moving into shelters or temporary housing. Follow-up examinations were conducted in March 2018 to identify patients who became overweight. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated using a Cox proportional hazards regression model. RESULTS: Among 15,875 participants (6091 men and 9784 women; mean age 63.0 ± 11.1 years) who received follow-up examination (mean follow-up, 4.29 years), 2042 (856 men and 1186 women) became overweight. Age-, baseline body mass index-, lifestyle-, and psychosocial status-adjusted HRs (95% CIs) for becoming overweight after evacuation were 1.44 (1.24-1.66) for men and 1.66 (1.47-1.89) for women. CONCLUSION: Evacuation was associated with the risk of becoming overweight 7 years after the disaster. Thus, maintaining physical activity, healthy diet, and sleep quality and removing barriers to healthy behaviour caused by disasters, including anxiety concerning radiation, may prevent this health risk among evacuees.

Lung sound analysis is useful for monitoring therapy in patients with bronchial asthma

Background: Lung sound analysis (LSA) has been reported to be useful for predicting airway obstruction and inflammation in patients with bronchial asthma. Objectives: We examined whether the exhalation-to-inhalation sound pressure ratio in the middle frequency range (200-400 Hz) (E/I MF) is useful for monitoring therapy in patients with asthma. Methods: The study population comprised 84 patients with mild to moderate asthma whose LSA data were available before and after 1 year of daily treatment with (budesonide 800 μg). We analyzed whether the E/I MF before and after treatment was associated with the fractional exhaled nitric oxide (FeNO) level, sputum eosinophil percentage, respiratory function, and airway hyperresponsiveness. Results: Prior to treatment with budesonide, the E/I MF was significantly correlated with respiratory function, airway hyperresponsiveness, FeNO, and sputum eosinophil percentage. The cutoff values for the E/I MF to detect the abnormalities of respiratory function, FeNO, and sputum eosinophil percentage were 0.367, 0.358, and 0.363, respectively. With respect to the reference value, the E/I MF improved significantly in patients whose respiratory function and FeNO benefited from therapy with budesonide compared with patients whose respiratory function did not benefit from budesonide (odds ratios of 6.39 and 4.78, respectively). According to the multivariate analysis, patients whose E/I MF did not improve had a longer history of smoking (P=.038), poorer posttreatment respiratory function (P=.028), and higher posttreatment FeNO (P=.0095). Conclusion: Similar to respiratory function and FeNO, E/I MF based on LSA is a useful indicator for monitoring the efficacy of therapy in asthmatic patients (AU)

Introducción: El análisis de los sonidos pulmonares ha demostrado ser una prueba de utilidad para objetivar la presencia de obstrucción e inflamación en las vías respiratorias de pacientes con asma bronquial. Objetivos: Hemos evaluado si el cociente sonido inspiración-espiración por presión en el rango de frecuencias medias, de 200 a 400 Hz, (E/I MF) tenía utilidad en la evaluación de la respuesta al tratamiento en pacientes con asma bronquial. Métodos: El estudio incluyó 84 pacientes con asma leve o moderada que tuvieran registros de LSA antes y tras un año de tratamiento con 800 μg de budesonida inhalada. Analizamos si los cambios en E/I MF tras el tratamiento se correlacionaban con los cambios en los niveles de óxido nítrico en aire exhalado (FeNO), el porcentaje de eosinófilos en muestras de esputo inducido, la función pulmonar y la hiperreactividad bronquial. Resultados: Antes de iniciar el tratamiento con budesonida inhalada, el cociente E/I MF se correlacionaba significativamente con la función pulmonar, la hiperreactividad bronquial, los niveles de FeNO y el porcentaje de eosinófilos en las muestras de esputo. Los puntos de corte del cociente E/I MF para detectar valores anómalos en la función pulmonar, los niveles de FeNO, y el porcentaje de eosinófilos en esputo eran 0,367, 0,358 y 0,363 respectivamente. El cociente E/I MF mejoraba significativamente en el grupo de pacientes en los que la budesonida inhalada inducía cambios significativos en la función pulmonar o en los niveles, con respecto a los valores de referencia apropiados comparados con los de los grupos de pacientes que no presentaban mejoría en estos parámetros (odds ratios de 6,39 y 4,78, respectivamente). En un análisis multivariante los pacientes que no presentaban mejoras significativas en el cociente E/I MF presentaban una historia de tabaquismo activo significativamente más larga (p=,038), unos niveles de función pulmonar tras tratamiento significativamente más bajos (p=,028), y paralelamente unos niveles de FeNO, tras tratamiento, más elevados (p=,0095). Conclusiones: Al igual que la función pulmonar y los niveles de FeNO, el cociente E/I MF obtenido mediante el LSA es un indicador útil para evaluar la eficacia del tratamiento en pacientes con asma bronquial (AU)