Medicine
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Observational Study
Excessive physical activity duration may be a risk factor for hypertension in young and middle-aged populations.
Physical inactivity is known to cause many health problems globally each year. However, evidence regarding the interaction between excessive physical activity (PA) and blood pressure in young and middle-aged populations is limited. A multistage, stratified, random cluster sampling design was adopted to recruit representative samples. ⋯ Among the 1003 participants who performed vigorous-intensity PA for more than 450 min/wk, 82 had hypertension (8.2%) and 479 had prehypertension (47.8%). Long-term and sustained PA may increase the risk for hypertension in young and middle-aged subjects. An appropriate recommendation of PA duration should be encouraged in this cohort.
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Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is the most frequent autoimmune encephalitis in children, and its presentation is various. The disease can be triggered by various infections. ⋯ Reactivated EBV infection may trigger anti-NMDAR encephalitis in children, which has not been reported previously. Related possible virology tests should be completed while diagnosing the disease.
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Observational Study
Assessment of inter-rater agreement between physicians and their patients regarding medication adherence in a clinical questionnaire study.
While it is important to treat lifestyle-related diseases for the primary and secondary prevention of cardiovascular diseases, medication adherence is still poor. Although various causes of poor adherence have been reported, the differences between physicians and their patients regarding the recognition of medication adherence have not been well-investigated. We administered a questionnaire about medication adherence to 300 outpatients and their 23 cardiologists at the Department of Cardiology, Fukuoka University Hospital. ⋯ In a multivariate analysis, absence of hypertension [odds ratio (OR): 0.21, 95% confidence interval (CI): 0.09-0.50, P < .001), β-blocker usage (OR: 1.86, 95% CI: 1.11-3.12, P = .02), and biguanide usage (OR: 4.04, 95% CI: 1.43-11.41, P = .01) were independent predictors of disagreement with regard to forgetting medication. The inter-rater agreement between physicians and patients with regard to medication adherence was slight. An increase in inter-rater agreement should improve medication adherence.
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Observational Study
Impact of renal dysfunction on surgical outcomes in patients with aortic dissection.
Preoperative renal dysfunction is associated with mortality in patients who undergo coronary artery bypass graft and valve surgery. However, the role of preoperative renal dysfunction in type A aortic dissection (TAAD) remains unclear. This study aimed to evaluate the impact of preoperative renal dysfunction on the outcome of surgical intervention in patients with TAAD. ⋯ In addition, patients with renal dysfunction exhibited a lower 90-day survival rate than did patients without the condition (P of log-rank test = .005). Preoperative renal dysfunction may have a critical role in the surgical outcomes of patients with TAAD. Additional large-scale investigations are warranted.
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Assessment of sedentary behaviors in children and adolescents with type 1 diabetes (T1D), relative to the method of insulin therapy used, and in comparison to healthy controls. The study group consisted of 215 children with T1D, including 109 (50.7%) insulin pen and 106 (49.3%) insulqsain pump users. The control group comprised 115 healthy children. ⋯ There were no significant differences between the children using insulin pump and insulin pen in the "% in sedentary time" score (P = .294) and "mean daily breaks in sedentary time" (P = .251). The T1D is a serious encumbrance, leading to longer duration of sedentary time, in comparison to healthy controls. The type of insulin therapy did not significantly affect the percentage of the wear-day spent in sedentary time and mean daily breaks in sedentary time.