Medi Seminar

Recently, a study has found that the combination of heat waves and air pollution is fatal to the heart while the world is suffering from abnormally high temperatures. The risk of heart attack doubled, with women and the elderly particularly vulnerable.

The results of a study on the effects of heat waves and air pollution on myocardial infarction mortality, conducted by Professor Ruijun Xu, Department of Epidemiology, School of Public Health, Zhongshan University, China, were published in the international journal Circulation on the 24th (doi.org/10.1161/CIRCULATIONAHA.122.063504). ).

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Temperature extremes, including heat and cold, are associated with myocardial infarction (MI) incidence, but their effect on MI mortality has not been clearly established.

Particulate matter (PM 2.5) is also known to have an adverse effect on cardiovascular mortality, but whether and how extreme temperature changes and PM 2.5 interact on MI mortality is still unknown.

To confirm this, the researchers conducted a time-stratified case crossover study of 202,678 MI deaths in Jiangsu Province, China from 2015 to 2020 to investigate the association between extreme temperature changes and PM 2.5 incidence and MI mortality, and correlated them. The action effect was evaluated.

Daily temperature and PM 2.5 exposure were evaluated by extracting values ​​from a grid data set validated at each subject’s residential address, and exposure-response analysis was performed by applying a conditional logistic regression model, and the ratio due to crossover and the occurrence due to synergy index We estimated the odds ratio.

As a result of the analysis, the odds ratio of MI mortality related to heat waves and cold waves ranged from 1.18 to 1.74 and 1.04 to 1.12, respectively, and the increase in death risk was particularly large in heat waves.

The risk of fatal MI was 18% higher during a 2-day heat wave with a heat index above the 90th percentile (28.1-36.6°C) and 74% higher during a 4-day heat wave with a heat index above the 97.5th percentile (34.9-43°C).

Exposure to PM 2.5 was also significantly associated with increased mortality from MI, with heatwaves and particulate matter combined generally having higher mortality rates in heatwaves with greater intensity and longer duration.

The risk of fatal MI was twice as high during a 4-day heat wave with PM 2.5 above 37.5 µg/m³, but during a cold wave, elevated PM 2.5 levels did not increase the risk of MI by a similar level.

The risk of death was higher for women than for men during the heat wave and higher for adults over 80 years of age than for younger adults.

“This analysis provides consistent evidence that exposure to extreme heat and PM 2.5 is significantly associated with increased mortality from MI in women and older adults, but not to cold waves,” said the researchers. This suggests that it may be beneficial in preventing premature death due to

2023-08-01 03:04:32

#Heat #wave #fine #dust #fatal #heart #double #incidence #myocardial #infarction

Although the possibility of atrial fibrillation was raised when taking omega-3, a large-scale meta-analysis concluded that the risk was exaggerated.

The results of a meta-analysis of the possibility of atrial fibrillation according to omega-3 intake conducted by researchers including Frank Qian of the Harvard TH School of Public Health in the United States were published in the American Heart Association journal JACC on the 17th (doi.org/10.1016/j.jacc.2023.05.024).

In 2021, a study on the possibility of an increased risk of atrial fibrillation by omega-3 supplements was published in the Journal of the European Heart Association, sparking controversy over the effectiveness of omega-3.

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Various societies recommend high-dose administration of 2 to 4 g of omega-3 per day to prevent cardiovascular disease, but in previous studies, the risk of atrial fibrillation was particularly frequent in the high-dose administration group.

High-dose administration is essential for effectiveness, but it was a situation where the possibility of side effects due to high-dose administration had to be taken into account.

The research team launched a meta-analysis method that comprehensively analyzed 17 studies to determine whether omega-3 administration actually increased the risk of atrial fibrillation.

In the study, which included a total of 54,799 participants, the incidence of atrial fibrillation according to blood levels of each component (EPA, DPA, DHA) was followed up for an average of 13.3 years, and 7720 cases of atrial fibrillation were identified.

In multivariate analysis, the EPA level was not related to incident atrial fibrillation, and rather, the risk (HR) of atrial fibrillation for higher levels of DPA, DHA, and EPA+DHA was 0.89, 0.90, and 0.93, respectively, with a risk reduction of around 10% observed.

“Consumption of omega-3 fatty acids, including EPA, DPA, DHA and EPA+DHA, was not associated with an increased risk of atrial fibrillation,” the researchers concluded.

“With the known benefits of these fatty acids in preventing coronary artery disease, this study suggests that current dietary guidelines recommending the administration of fish or omega-3 supplements may be retained.”

2023-07-21 03:03:49

#Omega #Supplements #Atrial #Fibrillation #Risks #Exaggerated #decrease

Contrast-enhanced ultrasound (CEUS) is rapidly emerging as a means of diagnosing Crohn’s disease in children instead of endoscopy, which has concerns about invasion of the large intestine.

It is in the limelight as an important diagnostic tool with the advantage of being non-invasive and inexpensive. In particular, it is the first domestic study to prove its effectiveness and increase its usability.

Contrast-enhanced ultrasound is emerging as an important tool for diagnosing Crohn’s disease in children.

On the 24th, the Journal of Korean Medical Science, an international journal of the Korean Medical Association, will publish the results of a study on the effectiveness of contrast-enhanced ultrasound in diagnosing Crohn’s disease in children.

Crohn’s disease is one of the chronic inflammatory bowel diseases, which has not yet been conquered, and its prevalence is increasing significantly, becoming a challenge in the medical world.

In particular, when a child suffers from Crohn’s disease, there is a growing awareness in that it greatly affects growth and development due to nutritional imbalance. This is why the importance of early diagnosis is emphasized.

Currently, in the case of pediatric Crohn’s Hospital, endoscopy is commonly used.

However, endoscopy has the disadvantage of being invasive compared to the advantage of providing accurate mucosal information. In particular, in the case of children, it is true that they are more exposed to this risk because of the thickness of the large intestine as well as the thin mucous membrane.

Similarly, MRI, which is used as an alternative, has limitations in that a contrast agent must be taken and sedation is required according to the age of the child.

It is for this reason that contrast-enhanced ultrasound has emerged as an alternative. This is because it is non-invasive, relatively inexpensive, and easily accessible.

In particular, in the case of contrast-enhanced ultrasound, it can be used to confirm the severity of the disease, treatment response, and complications in that it can visualize the intestinal wall and mesenteric perfusion in real time.

However, unlike adult Crohn’s disease, for which evidence is being accumulated, there is still insufficient evidence on whether contrast-enhanced ultrasound can be applied to children.

Comparison of contrast-enhanced ultrasound epidemiological and clinical parameters according to disease activity

This is the background of a research team led by Professor Park So-won of Yonsei University College of Medicine conducting a study on the effectiveness of contrast-enhanced ultrasound for children with Crohn’s disease in Korea.

Accordingly, the research team performed contrast-enhanced ultrasound on pediatric Crohn’s disease patients from August 2020 to August 2021 and compared and analyzed it with a control group.

As a result, children with activated Crohn’s disease had an erythrocyte sedimentation rate (ESR) of 13.0 mm/hr on contrast-enhanced ultrasound, which was significantly higher than that of patients without (2.0 mm/hr).

C-reactive protein (CRP) showed the same trend. Children with active Crohn’s disease recorded 4.7 mg/dL, whereas children with inactive Crohn’s disease recorded only 0.55 mg/dL.

This trend was evident as the slope (gradient) at the apex (peak) on the tonic-enhanced ultrasound. The active group had a slope of 1.18 and the inactive group had a slope of 0.93, showing a clear difference.

“This study is significant in that it is the first study to show that there is a difference in the average slope at the peak according to Crohn’s disease activity,” the researchers said. “This quantification parameter is the difference in the ratio between peak height and time to peak It shows that synergy using this is possible.”

“Eventually, this means that contrast-enhanced ultrasound is very safe and inexpensive for pediatric patients and has sufficient utility as a tool that can specifically diagnose whether or not Crohn’s disease is activated,” he said.

2023-07-10 20:30:00

#Augmented #ultrasound #increase #utilization #Catch #Crohns #disease #children

A study has found that it is good for women over the age of 65 to get tested for human papillomavirus (HPV) as a catch-up form.

In the case of elderly women, it is contrary to the past practice that there is no practical benefit, and attention is paid to whether there will be any changes to the guidelines in the future.

A study has found that catch-up HPV tests are useful even for women over the age of 65.

On the 9th local time, the international journal PLoS Medicine published the results of a large-scale study on the effectiveness of HPV testing for elderly women (10.1371/journal.pmed.1004253).

Currently, HPV testing is recommended as the primary cervical cancer screening test due to its excellent sensitivity, but in the case of elderly women, it is excluded from guidelines because there is no practical benefit for it.

Although there are many recommendations for young women in each country’s guidelines, it is true that there is no specific specification for elderly women.

In particular, some studies have reported that HPV is not cost-effective in the case of elderly women, and controversy is still ongoing in the medical community.

This is also the reason why a research team led by Professor Mette Tranberg of Landers Medical University in Denmark conducted a large-scale follow-up study on this. The purpose is to find out what kind of benefits HPV testing actually gives to elderly women.

Accordingly, the research team conducted cervical cancer screening on 11,192 women aged 60 years or older and compared them with 33,387 women in the reference group and conducted a follow-up study.

As a result, there was a significant difference in the detection rate of cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+).

This is because 3.9 cases of CIN2+ were detected per 1,000 women who underwent cervical cancer screening, while only 0.3 cases per 1,000 in the control group.

The results showed that even elderly women benefit from being tested, given that those who develop CIN2+ or higher have a high risk of being diagnosed with terminal cancer.

In particular, the researchers explained that women who have been tested for HPV even once have a significantly higher chance of being tested again, which is a great help for health management.

Prof. Tranberg said, “Just by checking the CIN2+ detection rate, it shows that the catch-up HPV test in older women can clearly detect cancer early and even prevent it.” presents,” he said.

2023-07-10 02:36:18

#HPV #screening #recommended #years #age

A study has found that it is good for women over the age of 65 to get tested for human papillomavirus (HPV) as a catch-up form.

In the case of elderly women, it is contrary to the past practice that there is no practical benefit, and attention is paid to whether there will be any changes to the guidelines in the future.

A study has found that catch-up HPV tests are useful even for women over the age of 65.

On the 9th local time, the international journal PLoS Medicine published the results of a large-scale study on the effectiveness of HPV testing for elderly women (10.1371/journal.pmed.1004253).

Currently, HPV testing is recommended as the primary cervical cancer screening test due to its excellent sensitivity, but in the case of elderly women, it is excluded from guidelines because there is no practical benefit for it.

Although there are many recommendations for young women in each country’s guidelines, it is true that there is no specific specification for elderly women.

In particular, some studies have reported that HPV is not cost-effective in the case of elderly women, and controversy is still ongoing in the medical community.

This is also the reason why a research team led by Professor Mette Tranberg of Landers Medical University in Denmark conducted a large-scale follow-up study on this. The purpose is to find out what kind of benefits HPV testing actually gives to elderly women.

Accordingly, the research team conducted cervical cancer screening on 11,192 women aged 60 years or older and compared them with 33,387 women in the reference group and conducted a follow-up study.

As a result, there was a significant difference in the detection rate of cervical intraepithelial neoplasia (CIN) grade 2 or higher (CIN2+).

This is because 3.9 cases of CIN2+ were detected per 1,000 women who underwent cervical cancer screening, while only 0.3 cases per 1,000 in the control group.

The results showed that even elderly women benefit from being tested, given that those who develop CIN2+ or higher have a high risk of being diagnosed with terminal cancer.

In particular, the researchers explained that women who have been tested for HPV even once have a significantly higher chance of being tested again, which is a great help for health management.

Prof. Tranberg said, “Just by checking the CIN2+ detection rate, it shows that the catch-up HPV test in older women can clearly detect cancer early and even prevent it.” presents,” he said.

2023-07-10 02:36:18

#HPV #screening #recommended #years #age