Prevalence of risk factors and 10 year risk estimation of cardiovascular diseases among rural population of Mysuru, Karnataka

Background: Cardiovascular diseases (CVD) are leading cause of death among non-communicable diseases (NCD). Many people in developing countries are detected late and die from NCDs, often in their most productive years. Prevention of CVD is an essential step to control the epidemic of NCDs. Thus, this study was undertaken to assess the prevalence of risk factors and to estimate the risk of CVD in the next 10 years.Methods: A community based cross-sectional study was conducted among 608 individuals aged ≥40 years in rural area of Mysuru. Data was collected using Semi structured questionnaire and 10 year CVD risk was estimated using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts.Results: A total of 608 study participants (mean age 56.76±11.07 years; Male:Female ratio 1.2:1) were included in the study. The prevalence of tobacco (32.9%) and alcohol (20.1%) consumption was significantly higher among males compared with females. Hypertension, diabetes and obesity prevalence was 39.5%, 15.5% and 28.1% respectively. One-fifth of population had moderate (20-39%) estimated risk and 7.4% had very high (≥40%) risk of developing CVD event in next 10 years. The estimated high risk (≥30%) of CVD events was statistically higher among individuals who were non-literates, unemployed, physically inactive, middle and above socioeconomic status.Conclusions: In the present study, CVD risk factors and estimated risk of CVD were significantly prevalent in the rural population. The use of simple tools like WHO/ISH risk prediction charts to estimate CVD risk is recommended in low resource settings at Community level, as the benefit of screening outweighs the risk of missing an opportunity to prevent CVD.

Ten-Year Results of Reconstruction for Rheumatoid Cervical Spine Lesions and Occurrence Factor of Subaxial Subluxation

STUDY DESIGN: Retrospective chart review. PURPOSE: This study evaluated long-term surgical outcomes of computer-assisted reconstruction using transarticular or cervical pedicle screws for cervical spine lesions caused by advanced rheumatoid arthritis (RA). OVERVIEW OF LITERATURE: We routinely employ C1–C2 transarticular and cervical pedicle screw instrumentation to reconstruct advanced and unstable RA cervical lesions. However, few reports are available on the long-term results of surgical reconstruction for rheumatoid cervical disorders, particularly regarding cervical pedicle screw fixation. METHODS: Six subjects (all female) with RA cervical lesions who underwent atlantoaxial or occipitocervical fixation and were followed for at least 10 years were retrospectively studied. A frameless, stereotactic, optoelectronic, computed tomography-based image guidance system was used for correct screw placement. Variables including the Japanese Orthopaedic Association score, EuroQol, Ranawat value, and C2–C7 angle before and 2, 5, and 10 years after surgery were assessed along with the occurrence of subaxial subluxation (SAS). RESULTS: Mean age at initial surgery was 58.2±7 years (range, 51–68 years), and mean follow-up period was 141±11 months (range, 122–153 months). Lesions included atlantoaxial subluxation (AAS, n=2) and AAS+vertical subluxation (n=4). Mean C2–C7 lordotic angle before and 2, 5, and 10 years after surgery was 20.1°±6.1°, 21.0°±4.0°, 18.8°±4.7°, and 17.8°±5.3°, respectively. SAS did not occur in cases maintaining the C2–C7 lordotic angle. In two cases where the C2–C7 lordotic angle declined from 5 years postoperatively, SAS occurred at the C2–C3 level in one and at the C4–C5 level in the other, both of which required reoperation. CONCLUSIONS: Patients with rheumatoid cervical lesions who undergo atlantoaxial or occipitocervical fixation using C1–C2 transarticular or pedicle screws carry a risk of SAS for up to 10 years postoperatively, which may require reoperation.

FRAX-based intervention and assessment thresholds in seven Latin American countries

Age-specific intervention and assessment thresholds were developed for seven Latin American countries. The intervention threshold ranged from 1.2% (Ecuador) to 27.5% (Argentina) at the age of 50 and 90 years, respectively. In the Latin American countries, FRAX offers a substantial advance for the detection of subjects at high fracture risk.INTRODUCTION:Intervention thresholds are proposed using the Fracture Risk Assessment (FRAX) tool. We recommended their use to calculate the ten-year probability of fragility fracture (FF) in both, men and women with or without the inclusion of bone mineral density (BMD). The purpose of this study is to compute FRAX-based intervention and BMD assessment thresholds for seven Latin American countries in men and women ≥ 40 years.METHODS:The intervention threshold (IT) was set at a 10-year probability of a major osteoporotic fracture (MOF) equivalent to a woman with a prior FF and a body mass index (BMI) equal to 25.0 kg/m2 without BMD or other clinical risk factors. The lower assessment threshold was set at a 10-year probability of a MOF in women with BMI equal to 25.0 kg/m2, no previous fracture and no clinical risk factors. The upper assessment threshold was set at 1.2 times the IT.RESULTS:For the seven LA countries, the age-specific IT varied from 1.5 to 27.5% in Argentina, 3.8 to 25.2% in Brazil, 1.6 up to 20.0% in Chile, 0.6 to 10.2% in Colombia, 0.9 up to 13.6% in Ecuador, 2.6 to 20.0% in Mexico, and 0.7 up to 22.0% in Venezuela at the age of 40 and 90 years, respectively.CONCLUSIONS:In the LA countries, FRAX-based IT offers a substantial advance for the detection of men and women at high fracture risk, particularly in the elderly. The heterogeneity of IT between the LA countries indicates that country-specific FRAX models are appropriate rather than a global LA model (AU)

Estimating risk of stroke in elderly people by use of Framingham Stroke Risk Profile / 上海预防医学

Objective To explore the application of Framingham Stroke Risk Profile in elderly people. Methods A total of 5 148 people aged 55 years and older who received physical examination in a community were enrolled.Information of their healthy status and risk factors were collected by interview using a questionnaire.Height, weight, waist circumference (WC), and blood pressure as well as fasting plasma glucose ( FPG) , and serum lipid were measured. Results The average 10-year probabilities of stroke in elderly people were 9.79% in men and 6.20% in women ( P <0.05).Besides aging factor, higher risk probability in men might be related to their higher proportions of smoking and atrial fibrillation. In addition to blood pressure and FPG which were variables associated with risk profile, WC/height ratio ( WHR) and serum triglyceride level were associated with increased risk of stroke estimated by stroke risk profile (OR=1.598, 95%CI:1.371~1.864;OR=1.487, 95%CI:1.225~1.783), respectively. Conclusion Besides factors which had been included by risk profile, it is important to pay attention to weight control and triglyceride level.For elderly male, to quit smoking is an important measure that decreases their risk of stroke.

Estudio densitométrico de diez años de remodelación femoral tras la implantación de un vástago anatómico / Étude densitométrique de dix ans d'un remodelage fémoral après implantation d'une tige anatomique / A Ten-Year sensitometric study of femoral remodeling after implantation of an anatomical stem

Introducción: la absorciometría dual con rayos X es comúnmente utilizada para cuantificar la remodelación ósea periprotésico, normalmente en seguimientos a corto plazo. Objetivo: determinar los patrones de remodelado producidos por vástago anatómico, mediante la cuantificación de cambios en la densidad mineral ósea en las 7 zonas de Gruen, durante el seguimiento, así como analizar la influencia de otros factores en el remodelado óseo. Métodos: se realizó un estudio prospectivo (10 años de seguimiento) a un grupo de 39 pacientes a los que se implantó una prótesis total de cadera no cementada. Se utilizó la cadera sana contralateral como control. Para cuantificar la remodelación femoral periprotésica se utilizó la absorciometría dual con rayos X en las 7 zonas de Gruen. Las mediciones de masa ósea se realizaron a los 15 días, 1, 3 y 10 años tras la intervención en la cadera no operada y a los 15 días, 1, 3, 5 y 10 años de la operación en la cadera protetizada. Se analizó también la influencia de otros factores en el remodelado óseo (sexo, índice de masa corporal y masa ósea preoperatoria). Resultados: se halló un descenso de la densidad mineral ósea del 7 por ciento en la zona 1 de Gruen y del 24,1 por ciento en la zona 7 de Gruen al final del décimo año. El sexo, el índice de masa corporal y la masa ósea preoperatoria no fueron estadísticamente relevantes en su influencia sobre el remodelado óseo. Conclusión: la remodelación ósea periprotésica depende en su mayor parte del implante, no se halló correlación con sexo, índice de masa corporal o masa ósea preoperatoria(AU)

Introduction: Dual X-ray absorptiometry is commonly used to quantify periprosthetic bone remodeling, usually for short-term follow up. Objective: determine patterns of remodeling caused by anatomical stem, by quantifying changes in bone mineral density in the 7 Gruen zones during follow up and analyze the influence of other factors in bone remodeling. Methods: a prospective study (10 year follow-up) was performed to a group of 39 patients undergoing uncemented total hip prosthesis. The healthy hip was used as control. Dual X-ray absorptiometry in Gruen zones 7 was used to quantify the femoral periprosthetic remodeling. Bone mass measurements were performed at 15 days, 1, 3 and 10 years after surgery on the non-operated hip, and at 15 days, 1, 3, 5 and 10 years of operation in the prosthetic hip. The influence of other factors in bone remodeling (sex, body mass index, and preoperative bone mass) was also analyzed. Results: 7 percent of decrease in bone mineral density was found in Gruen zone 1 and 24.1 percent was found in Gruen zone 7 at the end of the tenth year of follow up. Sex, body mass index and preoperative bone density were not statistically significant in its influence on bone remodeling. Conclusions: periprosthetic bone remodeling depends mainly on the implant. No correlation has been found with sex, body mass index and preoperative preoperative bone density(AU)

Introduction: l'absorptiométrie biphotonique à rayons X est fréquemment utilisée pour évaluer le remodelage osseux péri-prothétique, notamment par des suivis à court terme. Objectif: le but de cette étude est de déterminer les standards du remodelage osseux péri-prothétique produits par une tige anatomique, et d'analyser également l'influence d'autres facteurs sur le remodelage osseux. Méthodes: une étude prospective (suivi de 10 ans) d'un groupe de 39 patients, ayant subi une implantation de prothèse de hanche sans ciment, a été réalisée. Afin d'évaluer le remodelage fémoral périprothétique, on a effectué une absorptiométrie biphotonique à rayons X dans les 7 zones de Gruen. On a mesuré la DMO de la hanche non-opérée aux 15 jours et 1, 3, et 10 ans après la chirurgie, ainsi que la DMO de la hanche opérée aux 15 jours et 1, 3, 5, et 10 ans après la chirurgie. On a également analysé le retentissement d'autres facteurs (sexe, indice de masse corporelle, densité osseuse préopératoire) sur le remodelage osseux. Résultats: à la fin de la dixième année, on a trouvé une perte de la DMO de 7 pourcent dans la zone 1, et de 24.1 pourcent dans la zone 7. Le sexe, l'indice de masse corporelle et la masse osseuse préopératoire n'ont pas statistiquement influé sur le remodelage osseux. Conclusions: le remodelage osseux péri-prothétique dépend notamment de l'implant ; on n'a pas trouvé de corrélation avec le sexe, l'indice de masse corporelle ou la densité osseuse préopératoire(AU)

Ten years of limnological monitoring of a modified natural lake in the tropics: Cote Lake, Costa Rica / Diez años de monitoreo limnológico de un lago natural modificado en los trópicos: el lago Cote, Costa Rica

It is located 650m above sea level along the boundary between the North Caribbean and Pacific slopes, near the Southern end of the volcanic Guanacaste mountain range. In the early 1980s the lake’s main outlet was dammed and the outflow was diverted into Arenal Reservoir. Lake Cote was first studied in 1990-1991, and later in 2001, before it was again modified by raising its dam by one meter to use its outflow for hydroelectricity. From 2002 to 2010 it has been monitored twice a year for changes in its limnology. Here I present a summary of its basic characteristics and an analysis of their changes through time. The lake is discontinuous polymictic, and sometimes develops a thermocline at 6m depth that may last for several days as evidenced by the occasional development of an anoxic layer close to the bottom. Since its modification for hydropower production, the surface water temperature has attained higher values than before. Oxygen levels in the lake show periods of hypoxia to anoxia in the hypolimnion, that have become more frequent since modification. Despite its turbid water, the lake has low levels of nutrient concentrations and of chlorophyll a. The trend in these parameters in recent times is a reduction in chlorophyll a and an increase in water transparency, implying a reduction in primary productivity. These changes are discussed in relationship with anthropogenic factors such as the modification of the lake and its management, changes in landscape around the lake and global climate change. Rev. Biol. Trop. 62 (2): 567-578. Epub 2014 June 01.

Esta localizado a 650m sobre el nivel del mar en el límite entre las llanuras del Norte y la vertiente del Pacífico en la Cordillera de Guanacaste, Costa Rica. Al inicio de la década de 1980 se construyó una represa en el río de desagüe y el caudal de salida fue desviado hacia el Embalse Arenal. Se realizó un primer estudio entre 1990 y 1991, y luego en el año 2001 antes de que se construyera una nueva modificación del lago mediante el levantamiento del nivel de la presa en un metro con el fin de utilizar la descarga para la producción de energía hidroeléctrica. Del 2002 al 2010 se realizó un monitoreo limnológico dos veces al año. Aquí se presenta un análisis de las principales características y de los cambios a través del tiempo. El lago es polimíctico discontinuo y desarrolla una termoclina intermitente a 6m de profundidad, la cual puede perdurar por varios días o semanas a juzgar por el desarrollo de una capa anóxica cercana al fondo. Desde su modificación la temperatura superficial del lago ha alcanzado valores mayores a los reportados con anterioridad. El hipolimnion muestra periodos de hipoxia a anoxia que se han vuelto más frecuentes. A pesar de la turbidez del lago, la concentración de nutrientes y de clorofila a son bajos. La tendencia en tiempos recientes es a una reducción de la clorofila a y un aumento en la trasparencia del agua. Estos cambios son similares a los observados en lagos donde se ha logrado atribuirlos al cambio climático global. También se pueden deber a la modificación del flujo del efluente por la operación intermitente de la planta hidroeléctrica, que favorece la acumulación de calor en la columna de agua. Esto debido a que otros factores, como el cambio en el uso del suelo en los alrededores del lago ocurrieron en la década de 1980, por lo que no se les puede atribuir una influencia en los cambios observados en los últimos 10 años.