A full evaluation of health conditions is necessary for the effective implementation of public health interventions. However, terms to address the intermediate state between health and disease are lacking, leading the public to overlook this state and thus increasing the risks of developing disease.A cross-sectional health survey of 1,473 randomly recruited Chinese Han adults of both sexes living in the central region of China. The criteria for diagnosis of subhealth was defined as the presence of ≥ 1 of the following abnormalities: body mass index ≥ 25 kg/m2 or waist circumference ≥ 102 cm in men and 88 cm in women; systolic pressure 120-139 mmHg and/or diastolic pressure 80-89 mmHg; serum triglyceride level ≥ 150 mg/dL and/or total cholesterol level ≥ 200 mg/dL and/or high-density lipoprotein cholesterol level < 40 mg/dL in men and 50 mg/dL in women; serum glucose level 110-125 mg/dL; estimated glomerular filtration rate 60-89 ml/min/1.73 m2; levels of liver enzymes in liver function tests between 41-59 U/L, or with fatty liver disease but < 33% of affected hepatocytes; levels of oxidative stress biomarkers beyond the reference range of 95%; or problems with both sleep quality and psychological state.The prevalences of subhealth and disease in the central region of China were 36.6% and 43.1%, respectively. The prevalence of disease increased from 26.3% in participants aged 20-39 years, to 47.6% and 78.9% for participants aged 40-59 years and those aged 60 years or older, respectively. Compared with participants aged 20-39, the prevalences of health and subhealth in participants aged 60 years or older decreased by 86.7% and 60.3%, respectively. The prevalence of subhealth was increased in association with increases in lifestyle risk scores, while the prevalences of both health and disease were reduced.The prevalences of subhealth and disease are high in central China. Subhealth is associated with high lifestyle risk scores. Both the health care sector and the public should pay more attention to subhealth. Lifestyle modifications and/or psychological interventions are needed to ameliorate these conditions.

BACKGROUND:

Currently, there is limited evidence about effective strategies to manage childhood obesity and the metabolic syndrome in school settings. The present study aims to analyse changes in the prevalence of being overweight/obese and having the metabolic syndrome in relation to a 10-month lifestyle intervention based on individualised face-to-face sessions and parental education in school settings.

METHODS:

The study sample comprised a cross-sectional sample of 96 overweight/obese Mexican children aged 6-12 years from eight schools. Clinical, anthropometric measurements and 24-h recalls were obtained during each of 13 visits. Laboratory measurements were determined at the beginning and end. The energy-reduced diet was based on dietary recommended intakes. Individualised structured daily meals and a physical activity plan, tailored-made for each child, were provided every 3 weeks at the schools. Parental attendance was required. Student's t-test, McNemar and Shapiro-Wilk tests and simple linear regression were used for the statistical analysis.

RESULTS:

The prevalence of metabolic syndrome fell significantly from 44% to 16% (P < 0.01), high blood pressure fell from 19% to 0%, hypertrigliceridaemia fell from 64% to 35%, high-density lipoprotein-cholesterol ≤ 40 fell from 60% to 41%, hyperglycaemia fell from 1% to 0%, and waist circumference ≥90th percentile fell from 72% to 57%. There was a 2.84 [95% confidence interval (CI) = -4.10 to -1.58; P < 0.01] significant decrease in body mass index percentile and in body-fat percentage (95% CI = -3.31 to -1.55; P < 0.01). Of the overweight children, 32% achieved normal-weight, whereas 24% of the obese ones converted to overweight and 1% reached normal-weight. Physical activity increased 16 min day(-1) (P = 0.02) and 2 days week(-1) .

CONCLUSIONS:

A school-setting lifestyle intervention led to a decreased prevalence of being overweight/obese and to a striking reduction in the prevalence of the metabolic syndrome in a sample of Mexican children.

BACKGROUND:

The epidemiological scenario of cardiovascular risk factors (CRFs) among elderly people in rural China is unclear. We seek to describe the distribution, burden and management of major CRFs among older Chinese people living in the rural community.

METHODS:

This cross-sectional study included 1538 participants in the Confucius Hometown Aging Project (2010-2011) of people ≥60 years of age (mean age 68.6 years; 59.1% women) who lived in a rural community nearby Qufu, Shandong, China. Data were collected through a face-to-face interview, a clinical examination and laboratory tests. We carried out descriptive analysis on the prevalence and management of major CRFs.

RESULTS:

The overall prevalence of current smoking, physical inactivity, hypertension, diabetes, high cholesterol and obesity were 13.8%, 83.7%, 76.0%, 26.6%, 42.4% and 13.1%, respectively: 82.8% and 50.4% of participants had ≥2 and ≥3, respectively, of the six CRFs. Prevalence of alcohol consumption was 18.7%. Men were more likely to smoke and consume alcohol than women, whereas women were more likely to be obese and physically inactive than men (p < 0.001). Prevalence of physical inactivity and hypertension increased with age, prevalence of alcohol intake and obesity decreased with age, and prevalence of smoking and diabetes was stable. Hypertension, diabetes and high cholesterol were treated in 60.6%, 68.1% and 41.1% of those with the disease, respectively, but only 11.3%, 13.7% and 31.7% achieved good control.

CONCLUSIONS:

CRFs are highly prevalent and poorly controlled among elderly people in rural China, where men and women have different CRF profiles. Intervention programs targeting major CRFs may improve the health of older people in China.

Laboratory animal regulations provide little guidance regarding duration of nonsurvival surgery requiring aseptic technique. We hypothesized that swine would experience no sepsis during nonsurvival cardiothoracic surgery accomplished by using clean technique and lasting 8 h or less. Incision sites of 5 male farm pigs (Sus scrofa) were shaved and then cleaned with alcohol and povidone-iodine. The surgeon wore sterile gloves, clean scrubs, and hair bonnet; assistants wore clean scrubs and nonsterile gloves; most instruments were autoclaved. A median sternotomy incision was used for thoracic cavity exposure, and the skull was exposed to allow induction of brain death. Heart rate, body temperature, and blood samples were obtained before surgery (0 h; baseline) and at 2, 4, 5 or 6, and 7 or 8 h thereafter. Statistical analysis by t-tests showed that heart rate was unchanged and body temperature increased after the 0-h (baseline) time point. Aerobic blood cultures were negative except for 2 samples that were positive for coagulase-negative Staphylococcus spp. at 4 h. RBC, Hgb, and Hct levels were decreased at 2 and 4 h, but WBC and platelets were unchanged. Other alterations included decreased glucose (at 7 or 8 h), increased BUN (at 5 or 6 h and 7 or 8 h) and creatinine (at 5 or 6 h), decreased Na(+) and Ca and increased K(+) (most time points), decreased total protein and albumin (most time points), and decreased globulin (at 7 or 8 h). Liver enzymes and bilirubin typically were unchanged, and cholesterol consistently was decreased. Together our results indicate a lack of sepsis for 8 h or less in pigs undergoing cardiothoracic surgery by using clean technique. These findings provide new and specific data regarding the use of aseptic technique during prolonged nonsurvival surgeries.

Lactobacillus plantarum Lp27 was isolated from Tibetan kefir grains. The Lp27 isolate survived a 3-h incubation at pH 2.0 and grew normally in 0.3% oxgall. In addition, the Lp27 isolate exhibited an adhesion ratio of 9.5±2.5% with Caco-2 cells. Antibiotic susceptibility tests indicated that the Lp27 isolate was sensitive to gentamicin, tetracycline, erythromycin, and chloramphenicol, and was resistant to vancomycin with a minimum inhibitory value of 23µg/mL. The Lp27 isolate inhibited cholesterol absorption through downregulation of Niemann-Pick C1-like 1 (NPC1L1) expression in Caco-2 cells. The Lp27 isolate was fed to hypercholesterolemic rats at a dose of 10(9) cfu/d for 4wk. The Lp27 feeding significantly lowered serum total cholesterol, low-density lipoprotein cholesterol, and triglycerides concentrations, but no change was observed in the serum high-density lipoprotein cholesterol concentrations. In addition, liver total cholesterol and triglycerides were decreased in the Lp27-fed group. The expression of NPC1L1 in the duodenum and jejunum was significantly decreased following Lp27 feeding. These results indicate that Lp27 might be an effective cholesterol-lowering probiotic and a possible mechanism for the cholesterol-reducing effects of probiotics.

This study assessed the clinical outcome of fluvastatin in addition to the standard regimen used now for treatment of chronic HCV in Egypt. A total of 80 patients with chronic hepatitis C virus infection fulfilled clinical, laboratory and histo-pathological criteria were ready for interferon therapy. They were divided into two groups: GI (N = 40) received standard treatment for HCV (Pegylated interferon and Ribavirin) and GII (N = 40) received standard treatment plus Fluvastatin (80 mg/daily). Six months before and after treatment liver function tests and HCV-RNA were evaluated. The results showed that addition of Fluvastatin to the standard HCV treatment (Pegylated interferon and Ribavirin) significantly increased sustained virological response (SVR) from (55%-62.5%; P < 0.01) and significantly decreased viral load in relapse patients (P < 0.001). No significant differences and correlations were found between serum levels of LDL-cholesterol and viral load before and after treatment in both groups.

Abstract

Background:

Modern computer systems allow limits to be set on the periods allowed for repetitive testing. We investigated a computerised system for managing potentially overtly frequent laboratory testing, calculating the financial savings obtained.

Methods:

In consultation with hospital physicians, tests were selected for which 'spare periods' (periods during which tests are barred) might be set to control repetitive testing. The tests were selected and spare periods determined based on known analyte variations in health and disease, variety of tissues or cells giving rise to analytes, clinical conditions and rate of change determining analyte levels, frequency with which doctors need information about the analytes and the logistical needs of the clinic.

Results:

The operation and acceptance of the system was explored with 23 analytes. Frequency filtering was subsequently introduced for 44 tests, each with their own spare periods. The proportion of tests barred was 0.56%, the most frequent of these being for total cholesterol, uric acid and HDL-cholesterol. The financial savings were 0.33% of the costs of all testing, with HbA1c, HDL-cholesterol and vitamin B12 yielding the largest savings. Following the introduction of the system the number of barred tests ultimately decreased, suggesting accommodation by the test requestors.

Conclusions:

Managing laboratory testing through computerised limits to prevent overtly frequent testing is feasible. The savings were relatively low, but sustaining the system takes little effort, giving little reason not to apply it. The findings will serve as a basis for improving the system and may guide others in introducing similar systems.

To evaluate safety and durability of once-daily and twice-daily darunavir/ritonavir (DRV/r)-based treatment in HIV patients in clinical practice.The Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) project is a prospective, observational, multicenter cohort created to assess the incidence of adverse events in patients receiving new antiretroviral drugs. Twenty-five Italian infectious diseases centers enroll patients and collect their data through this on-line system. Periodical evaluations of these patients, including physical examination and laboratory tests, were performed at baseline and every 6 months.Four hundred and twenty-nine patients were enrolled since May 2006. Eighty-five patients (19.8%) were prescribed once-daily DRV/r; 31 of them were treatment-naïve (36.5%). Among 54 (63.5%) treatment-experienced patients, 21 (38.9%) had undetectable viral load and started once-daily DRV/r as a simplification regimen. Patients on twice-daily regimen were older, more frequently lipodystrophic, HCV-coinfected, and in CDC stage C. In the following 24 months of follow-up, the viral load steadily decreased as well as the CD4 cell count rose. The reason for discontinuation did not significantly differ between groups. Mean blood glucose (BG) change from baseline did not show significant difference between groups, as well as high density lipoprotein cholesterol (HDL-C), triglycerides (TGL) and alanine transaminase (ALT). The survival curve shows that patients in the once-daily regimen withdrew treatment more frequently than those on twice-daily regimen (Log Rank Chi(2)P=0.009).Our study showed that DRV/r administrated both once daily or twice daily was safe and well tolerated with few discontinuations due to adverse events.

Smoking is one of the major risk factors for cardiovascular disease. In Poland, 25% of women and 42% of men smoke cigarette regularly. The risk of myocardial infarction decreased significantly after cessation of smoking. Tobacco prevention is an integral part of health policies implemented in our country. Smoking is an indispensable element in the assessment of risk of death from cardiovascular using SCORE algorithm used by the Program for Prevention and Early Detection of Cardiovascular Diseases, conducted by the National Health Fund.The study was conducted in 2009-2011 in Zgierz (lodzkie voivodship). Study group consisted of former participants of the Programme of Prevention and Early Detection of Cardiovascular Diseases in the years 2006-2008. Tool for the study was a questionnaire survey extended with the study card, where laboratory results were applied. SCORE risk assessment used charts for countries with high risk. In all patients, laboratory tests assessing total cholesterol, LDL cholesterol, HDL cholesterol and fasting glucose were made. Respondents were also performed two-measurement of blood pressure. For the calculations, the methods of descriptive statistics and analysis using the package Statistica 9.0 PL.The study sample consisted of 458 persons. Among the respondents, 27.4% women and 38.2% of men smoked cigarettes. For regular smokers were 144 people, including 26 claimed that smokes occasionally. 74 people have decided to stop smoking after participating in the preventive program. We observed a strong correlation between smoking and arterial hypertension and glucose intolerance.Should be stepped up preventive measures aimed at combating the prevalence of tobacco consumption in local communities.

This work was aimed to evaluate the prevalence of insulin resistance (IR) and metabolic syndrome in a large cohort of 40-60 years old patients with cardiovascular symptoms.A total of 500 consecutive males and females referred to coronarography and coronary catheterization, because of spontaneous or after load precordial pain plus denivelisation of ST segment by electrocardiography, were included. Besides standard clinical examinations, ergometry, echocardiography, fundamental laboratory tests, and several other laboratory examinations were also performed, including oral glucose toleration test (OGTT), total and high-density lipoprotein (HDL) cholesterol, triglycerides, apoprotein A1 and B, apolipoprotein (a), uric acid, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), cytokines (tumor necrosis factor α, TNFα, interleukin-1, IL-1, interleukin-6, IL-6), endothelin-1, as well as hormones (insulin, C peptide, leptin, growth hormone, cortisol).In 81.6% of patients, IR syndrome with compensatory hyperinsulinemia was found in a positive correlation with various symptoms of metabolic syndrome, including abdominal obesity, increased body mass index (BMI), dysglycemia, dyslipoproteinemia, coronary stenosis, decreased HDL level, and hypertension. Hirsutism with polycystic ovarian syndrome was found in 52% of examined women with IR. However, a normal coronary angiogram, called as a microvascular form of the angina pectoris (MIV-AP), was found in 14% of predominantly periclimacteric and benign hirsutic females with long-term disorders of menstrual cycle. Since these patients showed the same symptoms as their gender, age, BMI, and degree of coronary stenoses adjusted pairs with the macrovascular form (such as the same levels of several lipids, hormones and obesity measures), our data strongly support the view that MIV-AP might belong to the IR syndrome.Hyperinsulinemia and high prevalence of various symptoms of metabolic syndrome (MS) were found in high percentage of patients with after load precordial pain who were referred to coronarography. Similarly, in several women, MIV-AP was detected and its affiliation to MS suggested.