The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considere...The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. Severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.展开更多
Background: Workers’ health condition is an important issue. It affects not only the well-being of workers but also the firms and society as a whole through medical costs and productivity losses due to absenteeism an...Background: Workers’ health condition is an important issue. It affects not only the well-being of workers but also the firms and society as a whole through medical costs and productivity losses due to absenteeism and presenteeism. Data and Methods: Data were obtained from 1136 employees at an operational site of a large corporation. The dataset contained both medical checkups and working record information. Health factors affecting long-term absence (over three days in three months) were analyzed. Logistic regression models and the procedure for selecting proper covariates based on likelihood test statistics and the Akaike information criterion were used. Results: Among health factors, high-density lipoprotein cholesterol (HDL-C) and blood sugar levels were important in the selected model. For HDL-C, the odds ratio (OR) based on one standard deviation difference was 0.75 with a 95% confidence interval (CI) of 0.59 - 0.95. For blood sugar, the OR was 1.20 with a 95% CI of 1.01 - 1.42. Improving HDL-C and blood sugar levels would reduce long-term absence by 25% and 20%, respectively. Conclusion: Controlling HDL-C and blood sugar levels is important to reduce long-term absenteeism. These factors can be improved by modifying eating habits. Since the operational site has its own company cafeterias, which most employees use, nutritional intervention is relatively easy with little or no cost. It may be worthwhile to implement nutritional intervention, especially for patients with low HDL-C or high blood sugar levels. Limitations: The results of this study were based on one operational site of a corporation. The employees were mainly operators working inside the building. The results may be different from other types of jobs and working conditions, such as fieldwork. Analyses of different types of jobs and working conditions are necessary.展开更多
Background: The etiology of ovarian cancer is not well-understood;numerous metabolomics profiling, epidemiological, and hospital-based case control studies have associated abnormal levels of blood glucose and serum li...Background: The etiology of ovarian cancer is not well-understood;numerous metabolomics profiling, epidemiological, and hospital-based case control studies have associated abnormal levels of blood glucose and serum lipids with the risk and the prognosis of various types of cancers including ovarian cancer. The association between the risk of the incidence of ovarian cancer and the alterations in the levels of blood glucose and serum lipids is not well defined. Objective: In this study we aimed to compare the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in patients with different stages of ovarian cancer and healthy controls to determine how they relate to the risk and prognosis of ovarian cancer. Methodology: In a case-control cross sectional study, we enrolled ninety-nine Sudanese women, diagnosed with ovarian cancer but had not received any kind of treatment as the study group, and a control group of forty-one age-matched, apparently healthy women. The patients were classified according to the International Federation of Obstetricians and Gynecologists staging system into two groups: early stages (stage I & II) and late stages (stages III & IV). Blood glucose and serum lipids;triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were determined by enzymatic colorimetric methods using commercially available analytical kits. The IBM SPSS version 20 software was used for statistical analysis. A Mann-Whitney U test was used for comparison of the median concentrations of blood glucose, triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the study groups. Logistic regression model was used to estimate the relative risk of ovarian cancer in relation to levels of blood glucose and serum lipids. P value of 0.05 was considered significant. Results: Our data indicated significantly higher levels of blood glucose (p < 0.001), triacylglycerols (p = 0.002), and low-density lipoprotein cholesterol (p < 0.001), and lower levels of high-density lipoprotein cholesterol (p = 0.023), in ovarian cancer patients compared to the control subjects. No significant difference was found in the levels of blood glucose or any of the serum lipids between patients in the early stages (stage I & II) and those in late stages (stage III & IV) of ovarian cancer. The logistic regression analysis indicated significant association between the elevated levels of the blood glucose, triacylglycerols and low-density lipoprotein cholesterol and the risk of the ovarian cancer. Conclusion: We conclude that the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol differ significantly between ovarian cancer patients and the healthy control subjects. The risk of ovarian cancer was positively associated with the levels of blood glucose, triacylglycerols and low-density lipoprotein cholesterol, and negatively associated with levels of high-density lipoprotein cholesterol. Therefore, determination of blood glucose and serum lipids, particularly, triacylglycerols, low-density lipoprotein cholesterol may be helpful as diagnostic indicators of ovarian cancer (OC).展开更多
Background: Today’s lifestyle changes have resulted in changes in the pattern of diseases from infectious diseases to non-communicable diseases. One disease that threatens the community is hypercholesterolemia. Pharm...Background: Today’s lifestyle changes have resulted in changes in the pattern of diseases from infectious diseases to non-communicable diseases. One disease that threatens the community is hypercholesterolemia. Pharmacological therapy was performed often fails due to non-compliance hypercholesterolemia patients. One of the complementary therapies that can be done is by implementing reimprinting. Reimprinting is a development of the SEFT method (Spiritual Emotional Freedom Technique). Reimprinting is the implementation of SEFT therapy independently. Methods: The research design used was quasy experimental with a Randomized Pretest and Posttest Control Group Design. The variables observed in this study were cholesterol levels (total cholesterol, HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), triglycerides). The group of respondents in this study was divided into 2 groups, namely group 1 (not given an intervention) and group 2 (the group given the reimprinting intervention). To find out the effectiveness of the reimprinting method, a paired-samples t test was used with a significance of 0.05. Result: The results of the study showed that the administration of reimprinting intervention in hypercholesterolemia patients was effective in reducing total cholesterol levels, increasing HDL (High Density Lipoprotein) cholesterol levels and lowering LDL (Low Density Lipoprotein) cholesterol levels. Conclusion: Reimprinting is one type of complementary therapy that can be done as a support for pharmacological therapy given to hypercholesterolemia patients to improve the success of the therapy. To get optimal results, an active role is needed from health personnel to be able to apply reimprinting therapy, obedience of hypercholesterolemia patients to attend each therapy session, active hypercholesterolemia patients should perform therapy independently and obey any advice has been given by health workers to consume drugs routinely and adopt a healthy lifestyle.展开更多
Children from low-income families have a higher incidence for developing early onset cardio-metabolic disease risk factors. Optimal levels of health-related fitness may attenuate risk, but little research has examined...Children from low-income families have a higher incidence for developing early onset cardio-metabolic disease risk factors. Optimal levels of health-related fitness may attenuate risk, but little research has examined its relationships with individual cardio-metabolic blood markers in low-income children. The purpose of this study was to examine the prevalence and correlates of unfavorable cardio-metabolic blood profiles in children from low-income families. Data were collected and analyzed on 124 children (mean age = 10.4 ± 0.9 years;57 girls, 67 boys;97% Hispanic) recruited from three urban Title I schools from the state of Utah in the US Health-related fitness. Measures were collected using the validated FITNESSGRAM fitness test battery. The Cholestech LDX system was used to analyze students’ total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides (TRI), and blood glucose (BG). Capillary blood samples via finger sticks were collected while each student was in a fasted state before school hours. Unfavorable measurements were defined as TC ≥ 200 mg/dL, LDL ≥ 130 mg/dL, HDL 150 mg/dL, and BG ≥ 100 mg/dL (pre-diabetes). Approximately 5.3% of the total sample had unfavorable TC, 16.7% had unfavorable HDL, 16.0% had unfavorable LDL, 15.2% had unfavorable TRI, and 25.4% had unfavorable BG (pre-diabetes). Pearson’s chi-square tests revealed no significant differences between sexes on any unfavorable classification after alpha level adjustment (p > 0.01). When all parameters were analyzed as continuous variables, Spearman’s rank correlation revealed a statistically significant linear relationship between aerobic fitness and LDL in boys (rs = -?0.65, p - 0.46, p < 0.01), and between BMI and BG in girls (rs = 0.56, p < 0.01). Aerobic fitness relates to LDL cholesterol in low-income boys and BMI relates to HDL cholesterol and BG in low-income girls.展开更多
文摘The American Diabetes Association (ADA) 2013 guidelines state that a reasonable hemoglobin A1c goal for many nonpregnant adults with diabetes is less than 7.0% a hemoglobin A1c level of less than 6.5% may be considered in adults with short duration of diabetes, long life expectancy, and no significant cardiovascular disease if this can be achieved without significant hypoglycemia or other adverse effects of treatment. A hemoglobin A1c level less than 8.0% may be appropriate for patients with a history of severe hypoglycemia, limited life expectancy, advanced macrovascular and microvascular complications, extensive comorbidities, and long-standing diabetes in whom the hemoglobin A1c goal is difficult to attain despite multiple glucoselowering drugs including insulin. The ADA 2013 guidelines recommend that the systolic blood pressure in most diabetics with hypertension should be reduced to less than 140 mmHg. These guidelines also recommend use of an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker in the treatment of hypertension in diabetics unless they are pregnant. Diabetics at high risk for cardiovascular events should have theirserum low-density lipoprotein (LDL) cholesterol lowered to less than 70 mg/dL with statins. Lower-risk diabetics should have their serum LDL cholesterol reduced to less than 100 mg/dL. Combination therapy of a statin with either a fibrate or niacin has not been shown to provide additional cardiovascular benefit above statin therapy alone and is not recommended. Hypertriglyceridemia should be treated with dietary and lifestyle changes. Severe hypertriglyceridemia should be treated with drug therapy to reduce the risk of acute pancreatitis.
文摘Background: Workers’ health condition is an important issue. It affects not only the well-being of workers but also the firms and society as a whole through medical costs and productivity losses due to absenteeism and presenteeism. Data and Methods: Data were obtained from 1136 employees at an operational site of a large corporation. The dataset contained both medical checkups and working record information. Health factors affecting long-term absence (over three days in three months) were analyzed. Logistic regression models and the procedure for selecting proper covariates based on likelihood test statistics and the Akaike information criterion were used. Results: Among health factors, high-density lipoprotein cholesterol (HDL-C) and blood sugar levels were important in the selected model. For HDL-C, the odds ratio (OR) based on one standard deviation difference was 0.75 with a 95% confidence interval (CI) of 0.59 - 0.95. For blood sugar, the OR was 1.20 with a 95% CI of 1.01 - 1.42. Improving HDL-C and blood sugar levels would reduce long-term absence by 25% and 20%, respectively. Conclusion: Controlling HDL-C and blood sugar levels is important to reduce long-term absenteeism. These factors can be improved by modifying eating habits. Since the operational site has its own company cafeterias, which most employees use, nutritional intervention is relatively easy with little or no cost. It may be worthwhile to implement nutritional intervention, especially for patients with low HDL-C or high blood sugar levels. Limitations: The results of this study were based on one operational site of a corporation. The employees were mainly operators working inside the building. The results may be different from other types of jobs and working conditions, such as fieldwork. Analyses of different types of jobs and working conditions are necessary.
文摘Background: The etiology of ovarian cancer is not well-understood;numerous metabolomics profiling, epidemiological, and hospital-based case control studies have associated abnormal levels of blood glucose and serum lipids with the risk and the prognosis of various types of cancers including ovarian cancer. The association between the risk of the incidence of ovarian cancer and the alterations in the levels of blood glucose and serum lipids is not well defined. Objective: In this study we aimed to compare the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol in patients with different stages of ovarian cancer and healthy controls to determine how they relate to the risk and prognosis of ovarian cancer. Methodology: In a case-control cross sectional study, we enrolled ninety-nine Sudanese women, diagnosed with ovarian cancer but had not received any kind of treatment as the study group, and a control group of forty-one age-matched, apparently healthy women. The patients were classified according to the International Federation of Obstetricians and Gynecologists staging system into two groups: early stages (stage I & II) and late stages (stages III & IV). Blood glucose and serum lipids;triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were determined by enzymatic colorimetric methods using commercially available analytical kits. The IBM SPSS version 20 software was used for statistical analysis. A Mann-Whitney U test was used for comparison of the median concentrations of blood glucose, triacylglycerols, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the study groups. Logistic regression model was used to estimate the relative risk of ovarian cancer in relation to levels of blood glucose and serum lipids. P value of 0.05 was considered significant. Results: Our data indicated significantly higher levels of blood glucose (p < 0.001), triacylglycerols (p = 0.002), and low-density lipoprotein cholesterol (p < 0.001), and lower levels of high-density lipoprotein cholesterol (p = 0.023), in ovarian cancer patients compared to the control subjects. No significant difference was found in the levels of blood glucose or any of the serum lipids between patients in the early stages (stage I & II) and those in late stages (stage III & IV) of ovarian cancer. The logistic regression analysis indicated significant association between the elevated levels of the blood glucose, triacylglycerols and low-density lipoprotein cholesterol and the risk of the ovarian cancer. Conclusion: We conclude that the levels of blood glucose, triacylglycerols, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol differ significantly between ovarian cancer patients and the healthy control subjects. The risk of ovarian cancer was positively associated with the levels of blood glucose, triacylglycerols and low-density lipoprotein cholesterol, and negatively associated with levels of high-density lipoprotein cholesterol. Therefore, determination of blood glucose and serum lipids, particularly, triacylglycerols, low-density lipoprotein cholesterol may be helpful as diagnostic indicators of ovarian cancer (OC).
文摘Background: Today’s lifestyle changes have resulted in changes in the pattern of diseases from infectious diseases to non-communicable diseases. One disease that threatens the community is hypercholesterolemia. Pharmacological therapy was performed often fails due to non-compliance hypercholesterolemia patients. One of the complementary therapies that can be done is by implementing reimprinting. Reimprinting is a development of the SEFT method (Spiritual Emotional Freedom Technique). Reimprinting is the implementation of SEFT therapy independently. Methods: The research design used was quasy experimental with a Randomized Pretest and Posttest Control Group Design. The variables observed in this study were cholesterol levels (total cholesterol, HDL (High Density Lipoprotein), LDL (Low Density Lipoprotein), triglycerides). The group of respondents in this study was divided into 2 groups, namely group 1 (not given an intervention) and group 2 (the group given the reimprinting intervention). To find out the effectiveness of the reimprinting method, a paired-samples t test was used with a significance of 0.05. Result: The results of the study showed that the administration of reimprinting intervention in hypercholesterolemia patients was effective in reducing total cholesterol levels, increasing HDL (High Density Lipoprotein) cholesterol levels and lowering LDL (Low Density Lipoprotein) cholesterol levels. Conclusion: Reimprinting is one type of complementary therapy that can be done as a support for pharmacological therapy given to hypercholesterolemia patients to improve the success of the therapy. To get optimal results, an active role is needed from health personnel to be able to apply reimprinting therapy, obedience of hypercholesterolemia patients to attend each therapy session, active hypercholesterolemia patients should perform therapy independently and obey any advice has been given by health workers to consume drugs routinely and adopt a healthy lifestyle.
文摘Children from low-income families have a higher incidence for developing early onset cardio-metabolic disease risk factors. Optimal levels of health-related fitness may attenuate risk, but little research has examined its relationships with individual cardio-metabolic blood markers in low-income children. The purpose of this study was to examine the prevalence and correlates of unfavorable cardio-metabolic blood profiles in children from low-income families. Data were collected and analyzed on 124 children (mean age = 10.4 ± 0.9 years;57 girls, 67 boys;97% Hispanic) recruited from three urban Title I schools from the state of Utah in the US Health-related fitness. Measures were collected using the validated FITNESSGRAM fitness test battery. The Cholestech LDX system was used to analyze students’ total cholesterol (TC), LDL cholesterol, HDL cholesterol, triglycerides (TRI), and blood glucose (BG). Capillary blood samples via finger sticks were collected while each student was in a fasted state before school hours. Unfavorable measurements were defined as TC ≥ 200 mg/dL, LDL ≥ 130 mg/dL, HDL 150 mg/dL, and BG ≥ 100 mg/dL (pre-diabetes). Approximately 5.3% of the total sample had unfavorable TC, 16.7% had unfavorable HDL, 16.0% had unfavorable LDL, 15.2% had unfavorable TRI, and 25.4% had unfavorable BG (pre-diabetes). Pearson’s chi-square tests revealed no significant differences between sexes on any unfavorable classification after alpha level adjustment (p > 0.01). When all parameters were analyzed as continuous variables, Spearman’s rank correlation revealed a statistically significant linear relationship between aerobic fitness and LDL in boys (rs = -?0.65, p - 0.46, p < 0.01), and between BMI and BG in girls (rs = 0.56, p < 0.01). Aerobic fitness relates to LDL cholesterol in low-income boys and BMI relates to HDL cholesterol and BG in low-income girls.
