ABSTRACT
Although hypertension is a well-known risk factor for chronic kidney disease (CKD), the blood pressure (BP) at which antihypertensive interventions should be initiated remains to be determined. Therefore, we investigated the association between BP and CKD in treatment-naïve individuals. Methods: This prospective cohort study considered 7,343 individuals in the Korean Genome and Epidemiology Study who were not taking antihypertensive medications. Subjects were categorized into six groups according to their systolic BP (SBP) and five groups according to their diastolic BP (DBP). The primary outcome was incident CKD, which was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 or the development of proteinuria. The secondary outcome was incident cardiovascular disease (CVD). Results: In the time-varying Cox models, the hazard ratios (95% confidence interval [CI]) for CKD were 1.39 (1.10–1.77) with SBP 130–139 mmHg, 1.79 (1.40–2.28) with SBP 140–159 mmHg, and 3.22 (2.35–4.40) with SBP ≥ 160 mmHg, compared with SBP 100–119 mmHg. In addition, the hazard ratios (95% CI) for CKD were 1.88 (1.48–2.37) with DBP 90–99 mmHg and 4.30 (3.20– 5.76) with DBP ≥ 100 mmHg, compared with DBP 70–79 mmHg. A significantly increased CVD risk was also observed in subjects with SBP ≥ 130 mmHg or DBP ≥ 90 mmHg. Conclusion: Our findings indicate that SBP ≥ 130 mmHg and DBP ≥ 90 mmHg are associated with an increased risk of CKD. Therefore, BP-lowering strategies should be considered starting at those thresholds to prevent CKD development.
ABSTRACT
Background@#Plasmodium vivax is a major pathogen that causes malaria in South Korea.Several genetic polymorphisms in dihydrofolate reductase (pvdhfr), P. vivax multidrug resistance protein 1 (pvmdr1 ), and P. vivax hydroxymethylpterin pyrophosphokinasedihydropteroate synthetase (pvdhps) genes are known to be associated with drug resistance in P. vivax. The objective of this study was to profile the known polymorphisms of P. vivax resistance genes in patients at a secondary hospital in South Korea. @*Methods@#A total of 12 patients with confirmed P. vivax infections were enrolled for this study. Sanger sequencing was performed for the pvdhfr, pvmdr1, and pvdhps genes to detect polymorphisms of these drug resistance genes. @*Results@#Each specimen had single or double polymorphism in pvdhfr. One specimen had a polymorphism in pvdhps. However, no specimen had any polymorphisms in pvmdr1. There was no strain with multi-polymorphisms exceeding double polymorphisms, which reported the geographic location of treatment failure. @*Conclusion@#No specimen showed chloroquine-resistance polymorphism in pvmdr1.Treatment with first-line therapy was successful. The prevalence of F57L in pvdhfr was higher than that reported previously. This change must be confirmed by further monitoring and surveillance of the strains with multi-polymorphisms.
ABSTRACT
Objective@#To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments. @*Methods@#The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion. @*Results@#Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD. @*Conclusion@#In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.
ABSTRACT
Objective@#To investigate the feasibility of a public health center-based aerobic and resistance training program for primary prevention of cardiovascular disease in people with visual, auditory, or physical/brain impairments. @*Methods@#The study included 25 adults aged >40 years who lived in Cheorwon-gun in South Korea, had a disability registered for visual, auditory, or physical/brain impairments under the Disability Welfare Act, and had either known cardiovascular disease or two or more risk factors for cardiovascular disease. The program comprised four education sessions and 12 weeks of customized aerobic and strengthening exercises performed twice a week at moderate intensity, with each exercise session lasting for 1 hour. The body mass index (BMI), percent body fat, 6-minute walk distance (6MWD), and 30-second sit-to-stand test results were measured at baseline and on program completion. @*Results@#Seventeen subjects (68%) completed the program. There were significant decreases in BMI and percent body fat (both p<0.05), with a significant increase in 30-second sit-to-stand strength (p<0.05) but no changes in the 6MWD. In subjects with visual or auditory impairments, BMI and percent body fat were significantly decreased after the program; however, there was no significant change in the results of the 30-second sit-to-stand strength test or the 6MWD. @*Conclusion@#In people with disabilities, a 3-month community-based exercise program can decrease body mass index and percent body fat and increase sit-to-stand strength. The 30-second sit-to-stand test may be a useful measure of the strength and endurance of the lower extremities in people with disabilities.
ABSTRACT
BACKGROUND: The immunologial alterations of tertian malaria are poorly understood. We investigated the hematological and immunological findings to know immunological mechanism of tertian malaria. METHODS: Forty patients with tertian malaria, hospitalized in the three affiliated hospitals of Catholic University Medical College, were enrolled in this study. The hematologic examination was performed by Coulter STKS. Atypical lymphocytes, eosinophils and plasmodium burden were counted manually. The immunoglobulin and complement concentrations were measured by nephelometry( Behring nephelometer analyzer, Germany) and automated chemiluminescence system(ACS 180, USA). The peripheral blood lymphocyte subsets were analyzed by flow cytometry using anti- CD3, CD4, CD8, CD19, CD25 and CD56 monoclonal antibodies(Becton Dickinson, San Jose, USA) and negative control. RESULTS: Anemia, lymphopenia, thrombocytopenia and eosinopenia were observed, and the eosinophil count was correlated to platelet count. The numbers of CD3+, CD8+, CD19+, CD56+, CD3-/CD56+ and CD8+/CD56+ lymphocytes were lower in tertian malaria than in control group(P<0.05). At 8th week after treatment, the percentage of CD8+ lymphocytes became significantly higher than before. The percentage of CD19+ lymphocytes was correlated to the number of eosinophils and thrombocytes(r=0.641, 0.417, P=0.000, 0.006). The serum concentrations of IgM and IgE were higher in tertian malaria than in control group. At 1st week after treatment, the IgE concentration became significantly lower than acute stage(P=0.014). The C3 and C4 concentrations were higher in tertian malaria than in control group. The C4 concentration became the same to the control group at the first week after treatment and was correlated to hemoglobin concentration. CONCLUSIONS: The eosinopenia with high IgE concentration could be a valuable marker of tertian malaria and IgE and C4 concentrations could be useful for serial monitoring after treatment.