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Objective:To determine the epidemiology of hyperkalemia and influencing factors in a general population in Pinggu district of Beijing city.Methods:This study was a cross-sectional survey. The subjects were from the epidemiological survey population of chronic diseases in Pinggu district of Beijing city from March to May 2014. All participants completed a questionnaire, anthropological measurement, and venous blood samples collection to detect serum creatinine and potassium and so on. First void morning urine was collected to detect the albumin-creatinine ratio. Hyperkalemia and hypokalemia were defined as serum potassium level>5.0 mmol/L and≤3.5 mmol/L, respectively. Logistic regression analysis method was used to analyze the influencing factors of hyperkalemia.Results:Of the 10 252 people in this study, the prevalence of hyperkalemia was 6.17%(95% CI 5.70%-6.67%), the prevalence of hypokalemia was 0.61%(95% CI 0.47%-0.79%), and the prevalence of participants with serum potassium>5.5 mmol/L was 0.53%(95% CI 0.40%-0.69%). Multivariate logistic regression analysis results showed that males ( OR=1.269, 95% CI 1.074-1.498, P=0.005), diabetes ( OR=1.226, 95% CI 1.008-1.490, P=0.041), increased total cholesterol ( OR=1.219, 95% CI 1.119-1.329, P<0.001), and decreased estimated glomerular filtration rate ( OR=0.971, 95% CI 0.965-0.977, P<0.001) were significantly correlated with the increased risk of hyperkalemia. Usage of renin-angiotensin-aldosterone system inhibitors and diuretics were not found to be significantly associated with the risk of hyperkalemia ( OR=1.018, 95% CI 0.751-1.380, P=0.908; OR=0.638, 95% CI 0.229-1.781, P=0.391). Conclusions:The prevalence of HK in the general population is 6.17%. The male, decreased estimated glomerular filtration rate, diabetes, and increased total cholesterol are influencing factors of hyperkalemia.
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ABSTRACT Objective: analyze the pattern of spatial distribution of the prevalence rate of births with congenital disorders and its relationship with social, economic, health care and environmental indicators in Paraná, Brazil, from 2008 to 2015. Method: ecological study with variables extracted from secondary banks, related to the births of children of mothers residing in Paraná, in two quadrennial (2008-2011 and 2012-2015). The analysis of the rates was performed with univariate spatial (Moran) and multivariate approach (Ordinary Least Squares and Geographically Weighted Regression). Results: the occurrence of congenital disorders presented a significant association (p<0.05) with: registration in primary care of pregnant women over 20 years of age; urbanization degree; consumption of pesticides; and balance of female formal employment. Conclusion/Final considerations: social, health care and environmental variables showed a non-stationary spatial pattern in the analyzed period and influenced positively and negatively the rates.
RESUMEN Objetivo: Evaluar el patrón de distribución espacial de la tasa de prevalencia de los nacimientos con anomalías congénitas y su relación con los indicadores sociales, económicos, medioambientales, de atención a la salud en el estado de Paraná, Brasil, de 2008 a 2015. Método: Estudio ecológico con variables de bancos secundarios, relativas a los nacimientos de hijos de madres residentes en el estado de Paraná, en dos cuatrienios (2008-2011 y 2012-2015). Se hizo el análisis de las tasas desde el análisis espacial univariada (Moran) y multivariante (Ordinary Least Squares y Geographically Weighted Regression). Resultados: La presencia de anomalías congénitas presentó una asociación significativa (p <0,05) con: el registro en la atención primaria de gestantes mayores de 20 años de edad; el grado de urbanización; el consumo de agrotóxicos; y el saldo de empleo formal femenino. Conclusión: Las variables sociales, medioambientales y de atención a la salud demostraron haber un patrón espacial no estacionario en el período analizado, además influenciaron positiva y negativamente las tasas.
RESUMO Objetivo: Analisar o padrão de distribuição espacial da taxa de prevalência dos nascimentos com anomalias congênitas e sua relação com indicadores sociais, econômicos, de atenção à saúde e ambientais no estado do Paraná, Brasil, de 2008 a 2015. Método: Estudo ecológico com variáveis extraídas de bancos secundários, relativas aos nascimentos de filhos de mães residentes no estado do Paraná, em dois quadriênios (2008-2011 e 2012-2015). A análise das taxas foi realizada com abordagem espacial univariada (Moran) e multivariada (Ordinary Least Squares e Geographically Weighted Regression). Resultados: A ocorrência de anomalias congênitas apresentou associação significativa (p<0,05) com: cadastramento na atenção primária de gestantes maiores de 20 anos; grau de urbanização; consumo de agrotóxicos; e saldo de emprego formal feminino. Conclusão: As variáveis sociais, de atenção à saúde e ambientais demonstraram padrão espacial não estacionário no período analisado e influenciaram positiva e negativamente as taxas.
Subject(s)
Adult , Female , Humans , Pregnancy , Geographic Mapping , Pesticides/adverse effects , Socioeconomic Factors , Urbanization/trends , Congenital Abnormalities/epidemiology , Brazil/epidemiology , Pregnancy Outcome/epidemiology , Retrospective Studies , EcosystemABSTRACT
La presentación del caso y su discusión diagnóstica constituye la forma de educación en el trabajo por excelencia en el proceso docente educativo y asistencial para la formación de los profesionales de la salud en los centros de enseñanza médica superior durante los estudios de pregrado y posgrado. Se fundamenta en la aplicación del método científico de las ciencias médicas (clínico y epidemiológico) y su interrelación con las categorías pedagógicas y principios didácticos fundamentales. Esta modalidad de educación en el trabajo es una de las más utilizadas, por cuanto se impone la necesidad de fortalecer la aplicación del método científico que la sustenta. El objetivo de esta revisión es identificar aspectos puntuales en torno al desarrollo de esta actividad docente asistencial y proponer algunas sugerencias para su desarrollo efectivo en el proceso enseñanza aprendizaje que puedan ser útiles para los profesionales de la salud que se desempeñan en aquellas especialidades que la practican de forma sistemática(AU)
The case report and its diagnostic discussion is the paramount form of education at work in the educative teaching and care-related process and for the training of health professionals in the centers of higher medical education during the undergraduate and postgraduate studies. It is based on the application of the scientific method of medical sciences (clinical and epidemiological) and its interrelation with the pedagogical categories and fundamental didactic principles. This type of education at work is one of the most used, because it imposes the need to strengthen the application of the scientific method that supports it. The objective of this review is to identify specific aspects about the development of this teaching assistance activity and to propose some suggestions for its effective development in the teaching learning process that may be useful for health professionals who work in those specialties that practice the method systematically(AU)
Subject(s)
Universities , Diagnosis , Education, Medical, Graduate , Education, Medical, Undergraduate , Clinical Decision-MakingABSTRACT
Objective To observe the changes of hospitalization rates of patients with goiter in Lianyungang City in a coastal area with mild iodine deficiency in 2002-2010.Methods Medical reports of patients with goiter from county hospitals were studied at county level with a retrospective method.In accordance with the National Iodized Salt Monitoring Program,nine townships(towns) were taken from each county (district) [total of five counties(districts)]; four villages were selected from each township (town); salt samples were taken from eight households in each village,and salt iodine was determined using direct titration of sodium thiosulfate.Results The hospitalization rate of patient with goiter increased from 1.87/10 million in 2002 to 7.05/10 million in 2009,and then fluctuated to 6.06/10 million in 2010(x2 =281.91,P＜ 0.01).Among them,female's hospitalization rates were significantly higher than that of male 's(The variation range of x2 values were 35.23-116.04,all P ＜ 0.01),and the hospitalization rates of people over the age of 40 years were significantly higher than that of people less than 40 years of age(The variation range of x2 values were 33.04-263.04,all P ＜ 0.01),and the hospitalization rates of people in urban areas were significantly higher than that of people in rural areas (The variation range of x2 values were 18.35-140.00,all P ＜ 0.01).Average salt iodine was 27.61-30.13 mg/kg in 2002-2010.The coverage rate of iodized salt and the consumption rate of qualified iodized salt both increased year by year (x2 =183.75,211.99,P ＜ 0.01).There was a positive correlation between hospitalization rate of patient with goiter and coverage rate of iodized salt(spearman correlation coefficient was 0.83,P ＜ 0.05).There was a positive correlation between hospitalization rate of patient with goiter and the consumption rate of qualified iodized salt too (spearman correlation coefficient was 0.93,P ＜ 0.05).Conclusions In Lianyungang City,the hospitalization rate of patient with goiter,the coverage rate of iodized salt and the consumption rate of qualified iodized salt all show upward trend in 2002-2010.The relationship among them is worth further study.
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OBJECTIVES: To reexamine the association between air pollution and daily mortality in Seoul, Korea using a method of meta-analysis with the data filed for 1991 through 1995. METHODS: A separate Poisson regression analysis on each district within the metropolitan area of Seoul was conducted to regress daily death counts on levels of each ambient air pollutant, such as total suspended particulates (TSP), sulfur dioxide (SO2), and ozone (O3), controlling for variability in the weather condition. We calculated a weighted mean as a meta-analysis summary of the estimates and its standard error. RESULTS: We found that the p value from each pollutant model to test the homogeneity assumption was small (p<0.01) because of the large disparity among district-specific estimates. Therefore, all results reported here were estimated from the random effect model. Using the weighted mean that we calculated, the mortality at a 100 microgram/m3 increment in a 3-day moving average of TSP levels was 1.034 (95% CI 1.009-1.059). The mortality was estimated to increase 6% (95% CI 3-10%) and 3% (95% CI 0-6%) with each 50 ppb increase for 3-day moving average of SO2 and 1-hr maximum O3, respectively. CONCLUSIONS: Like most of air pollution epidemiologic studies, this meta-analysis cannot avoid fleeing from measurement misclassification since no personal measurement was taken. However, we can expect that a measurement bias be reduced in a district-specific estimate since a monitoring station is better representative of air quality of the matched district. The similar results to those from the previous studies indicated existence of health effect of air pollution at current levels in many industrialized countries, including Korea.