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Morita T, Nomura S, Tsubokura M, Leppold C, Gilmour S, Ochi S, Ozaki A, Shimada Y, Yamamoto K, Inoue M, Kato S, Shibuya K, Kami M. Excess mortality due to indirect health effects of the 2011 triple disaster in Fukushima, Japan: a retrospective observational study. J Epidemiol Community Health 2017; 71:974-980. [DOI: 10.1136/jech-2016-208652] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/07/2017] [Accepted: 08/08/2017] [Indexed: 11/04/2022]
Abstract
BackgroundEvidence on the indirect health impacts of disasters is limited. We assessed the excess mortality risk associated with the indirect health impacts of the 2011 triple disaster (earthquake, tsunami and nuclear disaster) in Fukushima, Japan.MethodsThe mortality rates in Soma and Minamisoma cities in Fukushima from 2006 to 2015 were calculated using vital statistics and resident registrations. We investigated the excess mortality risk, defined as the increased mortality risk between postdisaster and predisaster after excluding direct deaths attributed to the physical force of the disaster. Multivariate Poisson regression models were used to estimate the relative risk (RR) of mortality after adjusting for city, age and year.ResultsThere were 6163 and 6125 predisaster and postdisaster deaths, respectively. The postdisaster mortality risk was significantly higher in the first month following the disaster (March 2011) than in the same month during the predisaster period (March 2006–2010). RRs among men and women were 2.64 (95% CI 2.16 to 3.24) and 2.46 (95% CI 1.99 to 3.03), respectively, demonstrating excess mortality risk due to the indirect health effects of the disaster. Age-specific subgroup analyses revealed a significantly higher mortality risk in women aged ≥85 years in the third month of the disaster compared with predisaster baseline, with an RR (95% CI) of 1.73 (1.23 to 2.44).ConclusionsIndirect health impacts are most severe in the first month of the disaster. Early public health support, especially for the elderly, can be an important factor for reducing the indirect health effects of a disaster.
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Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI JOURNAL 2017; 16:1057-1072. [PMID: 28900385 PMCID: PMC5579396 DOI: 10.17179/excli2017-480] [Citation(s) in RCA: 238] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 07/18/2017] [Indexed: 12/19/2022]
Abstract
Any intrinsic or extrinsic stimulus that evokes a biological response is known as stress. The compensatory responses to these stresses are known as stress responses. Based on the type, timing and severity of the applied stimulus, stress can exert various actions on the body ranging from alterations in homeostasis to life-threatening effects and death. In many cases, the pathophysiological complications of disease arise from stress and the subjects exposed to stress, e.g. those that work or live in stressful environments, have a higher likelihood of many disorders. Stress can be either a triggering or aggravating factor for many diseases and pathological conditions. In this study, we have reviewed some of the major effects of stress on the primary physiological systems of humans.
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Affiliation(s)
- Habib Yaribeygi
- Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Yunes Panahi
- Clinical Pharmacy Department, Faculty of Pharmacy, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hedayat Sahraei
- Neurosciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Thomas P Johnston
- Division of Pharmaceutical Sciences, School of Pharmacy, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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How Evacuees Obtained Health Care Information After the Great East Japan Earthquake: A Qualitative Interview Study. Disaster Med Public Health Prep 2017; 11:729-734. [PMID: 28659215 DOI: 10.1017/dmp.2017.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To explore how evacuees obtained health care information at their evacuation destinations after the Great East Japan Earthquake. METHODS We conducted semi-structured interviews of 11 evacuees who moved to City A in Kyoto Prefecture following the Great East Japan Earthquake. The interviews explored how the evacuees obtained health care information, including the main factors of influence. The interviews were transcribed and analyzed to identify trends by using the constant comparative method. RESULTS Four categories emerged from 6 concepts. Mother-children evacuees and family evacuees tended to obtain health care information in different ways. Family evacuees had moved as a family unit and had obtained their health care information from local neighbors. Mother-children evacuees were mothers who had moved with their children, leaving behind other family members. These evacuees tended to obtain information from other mother-children evacuees. At the time of evacuation, we found 2 factors, emotions and systems, influencing how mother-children evacuees obtained health care information. CONCLUSIONS We found 2 different ways of obtaining health care information among mother-children evacuees and other evacuees. At the time of evacuation, 2 factors, emotions and systems, influenced how mother-children evacuees obtained health care information. Community-building support should be a priority from an early stage after a disaster for health care management. (Disaster Med Public Health Preparedness. 2017;11:729-734).
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Zhang W, Ohira T, Yasumura S, Maeda M, Otsuru A, Harigane M, Horikoshi N, Suzuki Y, Yabe H, Nagai M, Nakano H, Hirosaki M, Uemura M, Takahashi H, Kamiya K, Yamashita S, Abe M. Effects of socioeconomic factors on cardiovascular-related symptoms among residents in Fukushima after the Great East Japan Earthquake: a cross-sectional study using data from the Fukushima Health Management Survey. BMJ Open 2017; 7:e014077. [PMID: 28645951 PMCID: PMC5541377 DOI: 10.1136/bmjopen-2016-014077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To investigate the association between socioeconomic factors and the exacerbation of cardiovascular symptoms among evacuees after the Great East Japan Earthquake. METHODS A sample of 73 433 individuals was included in the Fukushima Health Management Survey. Self-report questionnaires were used to determine the influence of socioeconomic factors including living arrangements, loss of employment and decreased income on the exacerbation of headache, dizziness, palpitations and shortness of breath. Odds ratios (ORs) and 95% CIs of the effect of socioeconomic factors were estimated for each symptom using multiple logistic regression analyses. RESULTS Exacerbation of headaches was reported by 1893 individuals, dizziness by 1229, palpitations by 1085 and shortness of breath by 626 individuals. Evacuation accommodation was associated with all of these symptoms. Compared with participants living in their own home (OR=1.00), individuals living in relatives' homes had increased probability of experiencing exacerbation of headache (1.58; 95% CI 1.19 to 2.09) and dizziness (1.42; 95% CI 1.02 to 1.98); those living in rental housing or apartments experienced exacerbation of headache (1.54; 95% CI 1.32 to 1.80), dizziness (1.45; 95% CI 1.20 to 1.75), palpitations (1.25; 95% CI 1.03 to 1.51) and shortness of breath (1.76; 95% CI 1.35 to 2.28); participants living in evacuation shelters experienced exacerbation of headache (1.80; 95% CI 1.09 to 2.96); and refugees living in temporary housing also experienced exacerbation of headache (1.42; 95% CI 1.15 to 1.72), dizziness (1.40; 95% CI 1.09 to 1.79) and shortness of breath (1.49; 95% CI 1.07 to 2.08). Compared with the evacuees who retained their jobs, unemployed individuals showed increased probability of exacerbation of headache (1.28, 95% CI 1.12 to 1.46), dizziness (1.26, 95% CI 1.07 to 1.48) and palpitations (1.21, 95% CI 1.01 to 1.45). Decreased income was associated with exacerbation of headache (1.39, 95% CI 1.22 to 1.60). CONCLUSION After the earthquake, living in non-home conditions was more likely to result in exacerbated cardiovascular symptoms among evacuees. Loss of employment was another risk factor related to exacerbated headache and dizziness.
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Affiliation(s)
- Wen Zhang
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Public Health, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masaharu Maeda
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Disaster Psychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Akira Otsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Mayumi Harigane
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Naoko Horikoshi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Yuriko Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Hirooki Yabe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Neuropsychiatry, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hironori Nakano
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mayumi Hirosaki
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Mayu Uemura
- Department of Epidemiology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
| | - Kenji Kamiya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Shunichi Yamashita
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
- Japan and Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima, Japan
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Miyata S, Sakata Y, Miura M, Yamauchi T, Onose T, Tsuji K, Abe R, Oikawa T, Kasahara S, Sato M, Nochioka K, Shiroto T, Takahashi J, Shimokawa H. Long-term prognostic impact of the Great East Japan Earthquake in patients with cardiovascular disease - Report from the CHART-2 Study. J Cardiol 2017; 70:286-296. [PMID: 28341543 DOI: 10.1016/j.jjcc.2016.10.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/10/2016] [Accepted: 10/17/2016] [Indexed: 11/19/2022]
Abstract
BACKGROUND We and others have previously reported that the Great East Japan Earthquake (GEJE) caused a significant but transient increase in cardiovascular diseases and deaths in the disaster area. However, it remains to be examined whether the GEJE had a long-term prognostic influence in large-scale cohort studies. This point is important when analyzing the data before and after the GEJE in the cohort studies in the disaster area. METHODS We examined 8676 patients registered in our Chronic Heart Failure Analysis and Registry in the Tohoku District-2 (CHART-2) Study (N=10,219) between 2006 and 2010 and were alive after March 10, 2011. RESULTS There were 48 GEJE-related deaths, causing a sharp and transient increase in all-cause death within a month after the GEJE. However, after excluding the GEJE-related deaths, the cubic polynomial spline smoothing showed no significant increase in all-cause death, heart failure admission, non-fetal acute myocardial infarction, or non-fetal stroke during the median 3-year follow-up after the GEJE. The extrapolation curves beyond the GEJE, which were obtained by the parametric survival models based on the survival data censored on the GEJE, were not significantly different from the Kaplan-Meier curves estimating the survival functions of deaths and cardiac events during the total follow-up period without considering the impacts of the GEJE. Furthermore, the multivariate Cox proportional hazard model applied to the matched cohort of the baseline data and the data after the GEJE showed no significant differences in the impacts of prognostic factors on all-cause mortality before and after the GEJE. CONCLUSIONS These results indicate that the GEJE had no significant long-term prognostic impact after the earthquake in cardiovascular patients in the disaster area.
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Affiliation(s)
- Satoshi Miyata
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Masanobu Miura
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takeshi Yamauchi
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takeo Onose
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kanako Tsuji
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ruri Abe
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuya Oikawa
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shintaro Kasahara
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masayuki Sato
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kotaro Nochioka
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine and Department of Evidence-Based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Hayashi Y, Nagai M, Ohira T, Satoh H, Sakai A, Ohtsuru A, Hosoya M, Kawasaki Y, Suzuki H, Takahashi A, Sugiura Y, Shishido H, Takahashi H, Yasumura S, Kazama JJ, Hashimoto S, Kobashi G, Ozasa K, Abe M. The impact of evacuation on the incidence of chronic kidney disease after the Great East Japan Earthquake: The Fukushima Health Management Survey. Clin Exp Nephrol 2017; 21:995-1002. [PMID: 28299459 PMCID: PMC5698380 DOI: 10.1007/s10157-017-1395-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 02/15/2017] [Indexed: 12/26/2022]
Abstract
Background About 146,000 people were forced into long-term evacuation due to the nuclear power plant accident caused by the Great East Japan Earthquake in 2011. Disaster is known to induce hypertension in survivors for a certain period, but it is unclear whether prolonged disaster stress influences chronic kidney disease (CKD). We conducted an observational cohort study to elucidate the effects of evacuation stress on CKD incidence. Methods Participants were individuals living in communities near the Fukushima nuclear power plant, aged 40–74 years without CKD as of their 2011 general health checkup (non-evacuees: n = 9780, evacuees: n = 4712). We followed new-onset CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 or proteinuria] using general annual health checkup data from 2012 to 2014. Association between evacuation and CKD incidence was analyzed using the Cox proportional hazard model. Results Mean age of the participants at baseline was 65 years, 46.7% were men, and baseline eGFR was 75.7 ml/min/1.73 m2. During the mean follow-up period of 2.46 years, CKD incidence rate was 80.8/1000 and 100.2/1000 person-years in non-evacuees and evacuees, respectively. Evacuation was a significant risk factor of CKD incidence after adjusting for age, gender, obesity, hypertension, diabetes, dyslipidemia, smoking, and baseline eGFR [hazard ratio (HR): 1.45; 95% confidence interval (CI) 1.35–1.56]. Evacuation was significantly associated with the incidence of eGFR <60 ml/min/1.73 m2 (HR: 1.48; 95% CI 1.37–1.60), but not with the incidence of proteinuria (HR: 1.21; 95% CI 0.93–1.56). Conclusion Evacuation was a risk factor associated with CKD incidence after the disaster.
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Affiliation(s)
- Yoshimitsu Hayashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan. .,Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, 960-1295, Japan.
| | - Masato Nagai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Tetsuya Ohira
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Satoh
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Diabetology, Endocrinology, and Metabolism, Fukushima Medical University, Fukushima, Japan
| | - Akira Sakai
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Radiation Life Sciences, Fukushima Medical University, Fukushima, Japan
| | - Akira Ohtsuru
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Radiation Health Management, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Yukihiko Kawasaki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Hitoshi Suzuki
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Cardiology, Fukushima Medical University, Fukushima, Japan
| | - Atsushi Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan
| | - Yoshihiro Sugiura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Neurology, Fukushima Medical University, Fukushima, Japan
| | - Hiroaki Shishido
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Orthopedics, Fukushima Medical University, Fukushima, Japan
| | - Hideto Takahashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Seiji Yasumura
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Public Health, Fukushima Medical University, Fukushima, Japan
| | - Junichiro James Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, 960-1295, Japan
| | - Shigeatsu Hashimoto
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
| | - Gen Kobashi
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Public Health, Dokkyo Medical University, Mibu, Japan
| | - Kotaro Ozasa
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan.,Department of Epidemiology, Radiation Effects Research Foundation, Fukushima, Japan
| | - Masafumi Abe
- Radiation Medical Science Center for the Fukushima Health Management Survey, Fukushima Medical University, Fukushima, Japan
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Modena MG, Pettorelli D, Lauria G, Giubertoni E, Mauro E, Martinotti V. Gender Differences in Post-Traumatic Stress. Biores Open Access 2017; 6:7-14. [PMID: 28289555 PMCID: PMC5327031 DOI: 10.1089/biores.2017.0004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Acute stress can trigger cardiovascular events and disease. The earthquake is an "ideal" natural experiment for acute and chronic stress, with impact mainly on the cardiovascular system. On May 20th and 29th, 2012, two earthquakes of magnitude 5.9° to 6.4° on the Richter scale, hit the province of Modena and Reggio Emilia, an area of the north-center of Italy never considered at seismic risk. The purpose of our study was to assess whether there were gender-specific differences in stress-induced incidence of cardiovascular events and age of patients who arrived at the Emergency Departments (ED) of the three main teaching hospitals of the University of Modena and Reggio Emilia. Global access of patients, divided in relation to age, gender, and diagnosis was compared with that one detected in the same departments and in the same interval of time in 2010. The data collected were relative to consecutive cases derived by retrospective chart and acute cardiovascular events were classified according to ICD-9 (International Classification of Diseases, ninth revision). A total of 1,401 accesses were recorded in the year of earthquake versus 530 in 2010 (p ≤ 0.05), with no statistically significant differences in number of cases and mean age in relation to gender, despite the number of women exceeded that of men in 2012 (730 vs. 671); the opposite occurred, in 2010 (328 vs. 202). The gender analysis of 2012 showed a prevalence of acute coronary syndromes (ACSs 177 vs. 73, p ≤ 0.03) in men, whereas women presented more strokes and transient ischemic attacks (TIAs) (90 vs. 94, p ≤ 0.05), atrial fibrillation (120 vs. 49, p ≤ 0.05), deep venous thrombosis and pulmonary embolism (DVT/PE; 64 vs. 9, p ≤ 0.05), panic attacks (124 vs. 26, p ≤ 0.03), aspecific chest pain (122 vs. 18, p ≤ 0.05), TakoTsubo cardiomyopathy (10 vs. 0, p ≤ 0.05), and DVT/PE (61 vs. 3, p ≤ 0.03). The gender analysis of 2010 showed no difference in number of accesses and age, with higher incidence of ACS in men (130 vs. 34, p ≤ 0.05) and aspecific chest pain in women (42 vs. 5, p ≤ 0.05). The analysis between 2012 and the standard period (2010) showed women recurring to ED in larger number with more panic attacks (124 vs. 3, p ≤ 0.01), more atrial fibrillation (120 vs. 40, p ≤ 0.01) and, as a possible consequence, more TIAs and strokes (190 vs. 25, p ≤ 0.005), more TakoTsubo (10 vs. 0, p ≤ 0.05), DVT/PE (61 vs. 3, p ≤ 0.05), and aspecific chest pain (122 vs. 5, p ≤ 0.01). The difference between men's accesses to ED was less striking, but in 2012 men reported more panic attacks (26 vs. none, p ≤ 0.05), more atrial fibrillations, TIAs, and strokes (49 vs. 13, p ≤ 0.05 and 94 vs. 18, p ≤ 0.03). In conclusion, clinical (stress induced) events recorded during and immediately after the 2012 earthquakes were quite different between women and men, although the pathophysiological mechanism was probably the same, consisting acute sympathetic nervous activation, with elevation of blood pressure and heart rate, endothelial dysfunction, platelet and hemostatic activation, increased blood viscosity, and hypercoagulation. Women, in our observation, appeared to be more sensitive and responsive to acute stress, although men also appeared to suffer from stress effects when compared with a standard period, which, nevertheless, reflects in our population the most common epidemiology of gender difference in ED accesses for cardiovascular events.
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Affiliation(s)
- Maria Grazia Modena
- Dipartimento Chirurgico, Medico, Odontoiatrico e di Scienze Morfologiche con interesse Trapiantologico, Oncologico e di Medicina Rigenerativa, UNIMORE, Modena, Italy
| | - Daniele Pettorelli
- Scuola di Specializzazione in Malattie Cardiovascolari Azienda Ospedaliera Universitaria Policlinico, Modena, Italy
| | - Giulia Lauria
- Scuola di Specializzazione in Malattie Cardiovascolari Azienda Ospedaliera Universitaria Policlinico, Modena, Italy
| | - Elisa Giubertoni
- Scuola di Specializzazione in Malattie Cardiovascolari Azienda Ospedaliera Universitaria Policlinico, Modena, Italy
| | - Erminio Mauro
- Scuola di Specializzazione in Malattie Cardiovascolari Azienda Ospedaliera Universitaria Policlinico, Modena, Italy
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Li N, Wang Y, Yu L, Song M, Wang L, Ji C, Wang X, Wu S. Long-term effects of earthquake experience of young persons on cardiovascular disease risk factors. Arch Med Sci 2017; 13:75-81. [PMID: 28144258 PMCID: PMC5206373 DOI: 10.5114/aoms.2017.64716] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 02/14/2015] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION The aim of the study was to study the long-term effect on cardiovascular disease risk factors of stress from direct experience of an earthquake as a young person. MATERIAL AND METHODS We selected workers born between July 1, 1958 and July 1, 1976 who were examined at Kailuan General Hospital between May and October of 2013. Data on cardiovascular events were taken during the workers' annual health examination conducted between 2006 and 2007. All subjects were divided into three groups according to their experience of the Tangshan earthquake of July 28, 1976, as follows: control group; exposed group 1 and exposed group 2. We compared cardiovascular disease risk factors between the three groups as well as by gender and age. RESULTS One thousand one hundred and ninety-six workers were included in the final statistical analysis. Among all subjects, resting heart rate (p = 0.003), total cholesterol (p < 0.001), and fasting blood glucose (p < 0.001) were significantly higher among those who experienced the earthquake compared with unexposed controls, but were unrelated to loss of relatives. No significant difference in triglyceride levels was observed between the three groups (p = 0.900). Further refinement showed that the effects were restricted to males 40 years of age or older at the time of analysis, but were due primarily to age at the time of earthquake exposure (p = 0.002, p < 0.001 and p = 0.002). CONCLUSIONS Earthquake experience in the early years of life has long-term effects on adult resting heart rate, total cholesterol, and fasting plasma glucose, especially among men.
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Affiliation(s)
- Na Li
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Yumei Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Lulu Yu
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Mei Song
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Lan Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Chunpeng Ji
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Xueyi Wang
- Department of Mental Health, the First Hospital of Hebei Medical University, Hebei Medical University Institute of Mental Health, Shijiazhuang, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
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Volchan E, Rocha-Rego V, Bastos AF, Oliveira JM, Franklin C, Gleiser S, Berger W, Souza GGL, Oliveira L, David IA, Erthal FS, Pereira MG, Figueira I. Immobility reactions under threat: A contribution to human defensive cascade and PTSD. Neurosci Biobehav Rev 2017; 76:29-38. [PMID: 28131873 DOI: 10.1016/j.neubiorev.2017.01.025] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/18/2017] [Accepted: 01/21/2017] [Indexed: 01/03/2023]
Abstract
Violence exacts a burden on public health. Gun violence is a major trigger for motor defensive reactions in humans and post-traumatic stress disorder (PTSD) is its main psychiatric sequela. However, studies of the human defensive cascade, especially the motor reactions, are at an early stage. This review focuses on studies that employ stabilometry, a methodology that assesses whole body motor reactions, to address defensive behaviors to violence-related threats. Special attention is given to three reactions: "attentive immobility", "immobility under attack" and "tonic immobility", with emphasis on the latter - a peritraumatic reaction which has been strongly associated with the severity of PTSD. These reactions are characterized by reduced body sway and bradycardia, except tonic immobility that presents robust tachycardia. The advances made by investigations into the immobility reactions of the human defensive cascade contribute to helping to bridge the gap between human and non-human species. Furthermore, progresses in basic research to objectively monitor motor defensive reactions under threat can help to develop a dimensional, trans-diagnostic approach to PTSD.
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Affiliation(s)
- E Volchan
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil.
| | - V Rocha-Rego
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - A F Bastos
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - J M Oliveira
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil; Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - C Franklin
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - S Gleiser
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - W Berger
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
| | - G G L Souza
- Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Brazil
| | - L Oliveira
- Instituto Biomédico, Universidade Federal Fluminense, Brazil
| | - I A David
- Instituto Biomédico, Universidade Federal Fluminense, Brazil
| | - F S Erthal
- Instituto de Biofisica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Brazil
| | - M G Pereira
- Instituto Biomédico, Universidade Federal Fluminense, Brazil
| | - I Figueira
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Brazil
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Mobula LM, Fisher ML, Lau N, Estelle A, Wood T, Plyler W. Prevalence of Hypertension among Patients Attending Mobile Medical Clinics in the Philippines after Typhoon Haiyan. PLOS CURRENTS 2016; 8. [PMID: 28286697 PMCID: PMC5325669 DOI: 10.1371/currents.dis.5aaeb105e840c72370e8e688835882ce] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: On November 8, 2013, Super Typhoon Haiyan struck the Philippines, causing a humanitarian emergency. According to the World Health Organization, non-communicable diseases (NCDs), also known as chronic diseases, are the leading cause of death and disability around the world. NCDs kill 38 million people each year. Sixteen million NCD deaths occur before the age of 70; 82% of which occurred in low- and middle-income countries. NCDs are further exacerbated during a crisis, and addressing them should be a concern of any medical disaster response. Methods: We conducted a retrospective observational study to determine the prevalence of hypertension among patients seeking medical care at mobile medical clinics after Typhoon Haiyan in the Philippines. Results: A total of 3,730 adults were evaluated at the mobile medical clinics. Analysis of the medical records revealed that the overall prevalence of hypertension among adult patients was 47%. Approximately 24% of adult females and 27% of adult males were classified with stage 2 Hypertension. Conclusions: Evidence-based guidelines on the management of hypertension and other NCDs (diabetes mellitus, cardiovascular disease, chronic lung disease and mental health) during humanitarian emergencies are limited. Clinical care of victims of humanitarian emergencies suffering with NCDs should be a critical part of disaster relief and recovery efforts. We therefore recommend the development of best practices and evidence based management guidelines of hypertension and other NCDs in post-disaster settings.
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Affiliation(s)
| | | | - Nathan Lau
- Bow Valley College, Calgary, Alberta, Canada
| | - Abi Estelle
- Oral and Maxillofacial Surgery, UF Health Jacksonville, Jacksonville, Florida. Samaritan's Purse
| | - Tom Wood
- Projects, Epidemiologist, Samaritan's Purse, Jonestown, Texas
| | - William Plyler
- Projects Department, Samaritan's Purse International Relief, Boone, North Carolina
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Nishizawa M, Hoshide S, Okawara Y, Matsuo T, Kario K. Strict Blood Pressure Control Achieved Using an ICT-Based Home Blood Pressure Monitoring System in a Catastrophically Damaged Area After a Disaster. J Clin Hypertens (Greenwich) 2016; 19:26-29. [DOI: 10.1111/jch.12864] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Revised: 05/02/2016] [Accepted: 05/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Masafumi Nishizawa
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
- Minamisanriku Hospital; Minami-sanriku Motoyoshi-gun Miyagi Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
| | - Yukie Okawara
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
| | - Takefumi Matsuo
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
- Hyogo Prefectural Awaji Medical Center; Shioya Sumoto-shi Hyogo Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine; Department of Medicine; Jichi Medical University School of Medicine; Shimotsuke Tochigi Japan
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62
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Kario K, Tomitani N, Matsumoto Y, Hamasaki H, Okawara Y, Kondo M, Nozue R, Yamagata H, Okura A, Hoshide S. Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension. Ann Glob Health 2016; 82:254-73. [DOI: 10.1016/j.aogh.2016.02.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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63
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Hinton AO, He Y, Xia Y, Xu P, Yang Y, Saito K, Wang C, Yan X, Shu G, Henderson A, Clegg DJ, Khan SA, Reynolds C, Wu Q, Tong Q, Xu Y. Estrogen Receptor-α in the Medial Amygdala Prevents Stress-Induced Elevations in Blood Pressure in Females. Hypertension 2016; 67:1321-30. [PMID: 27091896 DOI: 10.1161/hypertensionaha.116.07175] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 03/16/2016] [Indexed: 11/16/2022]
Abstract
Psychological stress contributes to the development of hypertension in humans. The ovarian hormone, estrogen, has been shown to prevent stress-induced pressor responses in females by unknown mechanisms. Here, we showed that the antihypertensive effects of estrogen during stress were blunted in female mice lacking estrogen receptor-α in the brain medial amygdala. Deletion of estrogen receptor-α in medial amygdala neurons also resulted in increased excitability of these neurons, associated with elevated ionotropic glutamate receptor expression. We further demonstrated that selective activation of medial amygdala neurons mimicked effects of stress to increase blood pressure in mice. Together, our results support a model where estrogen acts on estrogen receptor-α expressed by medial amygdala neurons to prevent stress-induced activation of these neurons, and therefore prevents pressor responses to stress.
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Affiliation(s)
- Antentor Othrell Hinton
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yanlin He
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yan Xia
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Pingwen Xu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yongjie Yang
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Kenji Saito
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Chunmei Wang
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Xiaofeng Yan
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Gang Shu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Alexander Henderson
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Deborah J Clegg
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Sohaib A Khan
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Corey Reynolds
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Qi Wu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Qingchun Tong
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.)
| | - Yong Xu
- From the Department of Pediatrics, Children's Nutrition Research Center (A.O.H., Y.H., Y.X., P.X., Y.Y., K.S., C.W., X.Y., G.S., A.H., Q.W., Y.X.), Advanced Technology/Core Laboratory (C.R.), and Department of Molecular and Cellular Biology (Y.X.), Baylor College of Medicine, One Baylor Plaza, Houston, TX; Department of Biomedical Research, Diabetes and Obesity Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA (D.J.C.); Department of Cell and Cancer Biology, Vontz Center for Molecular Studies, University of Cincinnati, College of Medicine, OH (S.A.K.); and Center for Metabolic and Degenerative Diseases, Brown Foundation Institute of Molecular Medicine, University of Texas Health Science Center at Houston (Q.T.).
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Kario K. Evidence and Perspectives on the 24-hour Management of Hypertension: Hemodynamic Biomarker-Initiated 'Anticipation Medicine' for Zero Cardiovascular Event. Prog Cardiovasc Dis 2016; 59:262-281. [PMID: 27080202 DOI: 10.1016/j.pcad.2016.04.001] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Accepted: 04/08/2016] [Indexed: 12/29/2022]
Abstract
There are notable differences between Asians and Westerners regarding hypertension (HTN) and the relationship between HTN and cardiovascular disease (CVD). Asians show greater morning surges in blood pressure (BP) and a steeper slope illustrating the link between higher BP and the risk of CVD events. It is thus particularly important for Asian hypertensives to achieve 24-h BP control, including morning and night-time control. There are three components of 'perfect 24-h BP control:' the 24-h BP level, nocturnal BP dipping, and BP variability (BPV), such as the morning BP surge that can be assessed by ambulatory BP monitoring. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-h BP control, followed by the control of nocturnal HTN. We have been developing new HBPM devices that can measure nocturnal BP. BPV includes different time-phase variability from the shortest beat-by-beat, positional, diurnal, day-by-day, visit-to-visit, seasonal, and yearly changes. The synergistic resonance of each type of BPV would produce a great dynamic BP surge (resonance hypothesis), which triggers a CVD event, especially in the high-risk patients with systemic hemodynamic atherothrombotic syndrome (SHATS). In the future, the innovative management of HTN based on the simultaneous assessment of the resonance of all of the BPV phenotypes using a beat by beat wearable 'surge' BP monitoring device (WSP) and an information and communication technology (ICT)-based data analysis system will produce a paradigm shift from 'dots' BP management to 'seamless' ultimate individualized 'anticipation medication' for reaching a zero CVD event rate.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan; Jichi Medical University Center of Excellence, Cardiovascular Research and Development (JCARD), Tochigi, Japan; Hypertension Cardiovascular Outcome Prevention and Evidence in Asia (HOPE Asia) Network, Tokyo, Japan.
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65
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Yokomichi H, Zheng W, Matsubara H, Ishikuro M, Kikuya M, Isojima T, Yokoya S, Tanaka T, Kato N, Chida S, Ono A, Hosoya M, Tanaka S, Kuriyama S, Kure S, Yamagata Z. Impact of the great east Japan earthquake on the body mass index of preschool children: a nationwide nursery school survey. BMJ Open 2016; 6:e010978. [PMID: 27056593 PMCID: PMC4838714 DOI: 10.1136/bmjopen-2015-010978] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 03/08/2016] [Accepted: 03/22/2016] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE To evaluate the impact of the 2011 great east Japan earthquake on body mass index (BMI) of preschool children. DESIGN Retrospective cohort study and ecological study. SETTING Affected prefectures (Fukushima, Miyagi and Iwate) and unaffected prefectures in northeast Japan. PARTICIPANTS The cohort study assessed 2033 and 1707 boys and 1909 and 1658 girls in 3 affected prefectures and unaffected prefectures, respectively, all aged 3-4 years at the time of the earthquake. The ecological study examined random samples of schoolchildren from the affected prefectures. PRIMARY AND SECONDARY OUTCOME MEASURES The cohort study compared postdisaster changes in BMIs and the prevalence of overweight and obese children. The ecological study evaluated postdisaster changes in the prevalence of overweight children. RESULTS 1 month after the earthquake, significantly increased BMIs were observed among girls (+0.087 kg/m(2) vs unaffected prefectures) in Fukushima and among boys and girls (+0.165 and +0.124 kg/m(2), respectively vs unaffected prefectures) in Iwate. 19 months after the earthquake, significantly increased BMIs were detected among boys and girls (+0.137 and +0.200 kg/m(2), respectively vs unaffected prefectures) in Fukushima, whereas significantly decreased BMIs were observed among boys and girls (-0.218 and -0.082 kg/m(2), respectively vs unaffected prefectures) in Miyagi. 1 month after the earthquake, Fukushima, Miyagi and Iwate had a slightly increased prevalence of overweight boys, whereas Fukushima had a slightly decreased prevalence of overweight girls, compared with the unaffected prefectures. The ecological study detected increases in the prevalence of overweight boys and girls in Fukushima who were 6-11 and 6-10 years of age, respectively. CONCLUSIONS These results suggest that in the affected prefectures, preschool children gained weight immediately after the earthquake. The long-term impact of the earthquake on early childhood growth was more variable among the affected prefectures, possibly as a result of different speeds of recovery.
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Affiliation(s)
- Hiroshi Yokomichi
- Department of Health Sciences, University of Yamanashi, Yamanashi, Japan
| | - Wei Zheng
- Department of Social Medicine and Health Education, Peking University, Beijing, China
| | - Hiroko Matsubara
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Miyagi, Japan
| | - Mami Ishikuro
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Miyagi, Japan
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Miyagi, Japan
| | | | - Susumu Yokoya
- Center for Clinical Research Data, National Center for Child Health and Development, Tokyo, Japan
| | | | - Noriko Kato
- Department of Early Childhood Care and Education, Jumonji University, Saitama, Japan
| | - Shoichi Chida
- Department of Pediatrics, Iwate Medical University, Iwate, Japan
| | - Atsushi Ono
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | - Mitsuaki Hosoya
- Department of Pediatrics, Fukushima Medical University, Fukushima, Japan
| | | | - Shinichi Kuriyama
- Department of Disaster Public Health, International Research Institute of Disaster Science, Tohoku University, Miyagi, Japan
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Miyagi, Japan
| | - Shigeo Kure
- Department of Pediatrics, Tohoku University, Miyagi, Japan
| | - Zentaro Yamagata
- Department of Health Sciences, University of Yamanashi, Yamanashi, Japan
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Shiraishi Y, Kujiraoka T, Hakuno D, Masaki N, Tokuno S, Adachi T. Elevation of Derivatives of Reactive Oxygen Metabolites Elevated in Young "Disaster Responders" in Hypertension due to Great East Japan Earthquake. Int Heart J 2016; 57:61-6. [PMID: 26742880 DOI: 10.1536/ihj.15-303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There have been very few studies on serum biomarkers associated with hypertension in disaster situations. We assessed biomarkers associated with disaster-related hypertension (DRH) due to the Great East Japan Earthquake of March 2011.We collected blood samples from members of the Japan Self Defense Forces (JSDF) (n = 77) after completing disaster relief operations. We divided them into two groups based on systolic blood pressure. We defined DRH as either systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mmHg at the time of completing missions.In subjects with DRH, the mean blood pressure was 143.5 ± 5.0/99.5 ± 2.4 mmHg. Height and body weight measurements were slightly greater in the DRH group but the differences were not significant, and age was significantly higher in the DRH group. There were no differences in serum biochemical tests including metabolic markers, sulfur-containing amino acids, and cytokines. Among nitric oxide-related amino acids, asymmetric dimethylarginine (ADMA) was lower in the DRH group than in the normotension group (0.40 ± 0.02 versus 0.31 ± 0.02 μmol/L P = 0.04). The serum oxidative stress metabolite levels (d-ROMs; indicators of active oxygen metabolite products) were significantly higher in the DRH group (273.6 ± 6.08 versus 313.5 ± 13.7 U.CARR P = 0.016). Using multivariable regression analysis, d-ROMs levels were particularly predictive for DRH.Oxidative stress is associated with DRH in responders to the disaster of the Great East Japan Earthquake.
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Affiliation(s)
- Yasunaga Shiraishi
- Department of Internal Medicine, Division of Cardiovascular Medicine, National Defense Medical College
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Lee DC, Gupta VK, Carr BG, Malik S, Ferguson B, Wall SP, Smith SW, Goldfrank LR. Acute post-disaster medical needs of patients with diabetes: emergency department use in New York City by diabetic adults after Hurricane Sandy. BMJ Open Diabetes Res Care 2016; 4:e000248. [PMID: 27547418 PMCID: PMC4964212 DOI: 10.1136/bmjdrc-2016-000248] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 06/13/2016] [Accepted: 07/01/2016] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To evaluate the acute impact of disasters on diabetic patients, we performed a geospatial analysis of emergency department (ED) use by New York City diabetic adults in the week after Hurricane Sandy. RESEARCH DESIGN AND METHODS Using an all-payer claims database, we retrospectively analyzed the demographics, insurance status, and medical comorbidities of post-disaster ED patients with diabetes who lived in the most geographically vulnerable areas. We compared the patterns of ED use among diabetic adults in the first week after Hurricane Sandy's landfall to utilization before the disaster in 2012. RESULTS In the highest level evacuation zone in New York City, postdisaster increases in ED visits for a primary or secondary diagnosis of diabetes were attributable to a significantly higher proportion of Medicare patients. Emergency visits for a primary diagnosis of diabetes had an increased frequency of certain comorbidities, including hypertension, recent procedure, and chronic skin ulcers. Patients with a history of diabetes visited EDs in increased numbers after Hurricane Sandy for a primary diagnosis of myocardial infarction, prescription refills, drug dependence, dialysis, among other conditions. CONCLUSIONS We found that diabetic adults aged 65 years and older are especially at risk for requiring postdisaster emergency care compared to other vulnerable populations. Our findings also suggest that there is a need to support diabetic adults particularly in the week after a disaster by ensuring access to medications, aftercare for patients who had a recent procedure, and optimize their cardiovascular health to reduce the risk of heart attacks.
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Affiliation(s)
- David C Lee
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
- Department of Population Health, New York University School of Medicine, New York, New York, USA
| | - Vibha K Gupta
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Brendan G Carr
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Department of Health & Human Services, Emergency Care Coordination Center, Office of the Assistant Secretary for Preparedness & Response, Washington, DC, USA
| | - Sidrah Malik
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Brandy Ferguson
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Stephen P Wall
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Silas W Smith
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
| | - Lewis R Goldfrank
- Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, New York, USA
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Guidelines for Disaster Medicine for Patients With Cardiovascular Diseases (JCS 2014/JSH 2014/JCC 2014) - Digest Version . Circ J 2015; 80:261-84. [PMID: 26632533 DOI: 10.1253/circj.cj-66-0121] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Changes in Hospitalization for Ischemic Heart Disease After the 2008 Sichuan Earthquake: 10 Years of Data in a Population of 300,000. Disaster Med Public Health Prep 2015; 10:203-10. [PMID: 26568199 DOI: 10.1017/dmp.2015.128] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The effects of earthquakes on ischemic heart disease (IHD) have often been reported. At a population level, this study examined short-term (60-day) and long-term (5-year) hospitalization events for IHD after the 2008 Sichuan earthquake. METHODS We examined the 10-year medical hospitalization records on IHD in the city of Deyang provided by the Urban Employee Basic Health Insurance program. RESULTS Evaluation of 19,083 hospitalizations showed a significantly lower proportional number and cost of hospitalizations in the 60 days after the earthquake (P<0.001). Hospitalizations were 27.81% lower than would have been expected in a normal year; costs were 32.53% lower. However, in the 5 years after the earthquake, the age-adjusted annual incidence of hospitalization increased significantly (P<0.001). In the fifth year after the earthquake, it was significantly higher in the extremely hard-hit area than in the hard-hit area (P<0.01). CONCLUSION After the 2008 earthquake, short- and long-term patterns of hospitalization for IHD changed greatly, but in different ways. Our findings suggest that medical resources for IHD should be distributed dynamically over time after an earthquake.
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Hao K, Takahashi J, Aoki T, Miyata S, Ito K, Sakata Y, Shimokawa H. Factors influencing the occurrence of cardiopulmonary arrest in the Great East Japan Earthquake disaster. Int J Cardiol 2014; 177:569-72. [PMID: 25194865 DOI: 10.1016/j.ijcard.2014.08.127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 08/21/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Kiyotaka Hao
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuo Aoki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Satoshi Miyata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kenta Ito
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuhiko Sakata
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Hiroaki Shimokawa
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
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Tomio J, Sato H. Emergency and disaster preparedness for chronically ill patients: a review of recommendations. Open Access Emerg Med 2014; 6:69-79. [PMID: 27147882 PMCID: PMC4753992 DOI: 10.2147/oaem.s48532] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Recent disasters, especially those in developed countries, have highlighted the importance of disaster preparedness measures for chronic diseases. A number of surviving patients experienced the exacerbation of a chronic illness, such as hypertension, diabetes, cancer, and chronic respiratory diseases, due to disaster-related stress, interruption of care, or both; for some patients, these exacerbations resulted in death. Here, we review reports from recent disasters in developed countries and summarize the recommendations for disaster preparedness of chronically ill patients. A considerable number of recommendations based on the lessons learned from recent disasters have been developed, and they provide practical and essential steps to prevent treatment interruption during and after a disaster. To improve preparedness efforts, we suggest that health care providers should be aware of the following three suggestions: 1) recommendations should be evidence-based; 2) recommendations should contain consistent messages; and 3) recommendations should be feasible.
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Affiliation(s)
- Jun Tomio
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hajime Sato
- Department of Health Policy and Technology Assessment, National Institute of Public Health, Wako, Japan
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Habr SF, Macrini DJ, Spinosa HDS, Florio JC, Bernardi MM. Repeated forced swim stress has additive effects in anxiety behavior and in cathecolamine levels of adult rats exposed to deltamethrin. Neurotoxicol Teratol 2014; 46:57-61. [DOI: 10.1016/j.ntt.2014.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 09/18/2014] [Accepted: 10/07/2014] [Indexed: 11/30/2022]
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Kiyohara K, Kitamura T, Iwami T, Nishiyama C, Kawamura T. Impact of the Great East Japan earthquake on out-of-hospital cardiac arrest with cardiac origin in non-disaster areas [corrected]. J Epidemiol Community Health 2014; 69:185-8. [PMID: 25240062 DOI: 10.1136/jech-2014-204380] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND To examine changes in the incidence of out-of-hospital cardiac arrest (OHCA) with cardiac origin in the non-disaster areas of Japan before and after the Great East Japan Earthquake of 11 March 2011. METHODS The 35 prefectures in Japan with no dead or missing caused directly by the earthquake were defined as the non-disaster areas. Data of adult OHCA patients in the non-disaster areas from March 4 to 24 each year from 2005 to 2011 were obtained from the All-Japan Utstein Registry. Risk ratios (RRs) of OHCA incidence and 95% CIs were estimated for three specific weeks in 2011 (1 week before and 2 weeks after the earthquake) by applying multivariable Poisson regression model. Incidence in the corresponding periods of March 4-24 from 2005 to 2010 was set as the baseline risk. RESULTS In the analyses from a total of 17,353 OHCA patients, the incidence statistically significantly increased in the first week after the earthquake in all adults (adjusted-RR=1.13, 95% CI=1.05 to 1.22, p=0.001) and in elderly women (adjusted-RR=1.23, 95% CI=1.11 to 1.37, p<0.001). CONCLUSIONS The Great East Japan Earthquake caused the increase of OHCA among elderly women even in the non-disaster areas.
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Affiliation(s)
- Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Shinjuku-ku, Tokyo
| | - Tetsuhisa Kitamura
- Division of Environmental Medicine and Population Sciences, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka
| | - Taku Iwami
- Kyoto University Health Service, Kyoto, Kyoto
| | - Chika Nishiyama
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Kyoto
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Kang K. Disaster preparedness among vulnerable older adults with chronic diseases: Results from a cross-sectional study in Incheon, Korea. Nurs Health Sci 2014; 16:46-51. [DOI: 10.1111/nhs.12133] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Kyunghee Kang
- Department of Emergency Health Science; Gachon University; Incheon Korea
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Watanabe T. [The 41st Scientific Meeting: perspectives of internal medicine; lessons from the disaster of the Great East Japan earthquake: 3. Medical disease learned from the Great East Japan earthquake--feature, treatment and prevention--; 4) Status of medical care on dialysis patients and patients with chronic life-style related diseases after Great East-Japan earthquake: lesson from our experiences in Fukushima and future perspectives]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:561-571. [PMID: 24796117 DOI: 10.2169/naika.103.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Suzuki H, Yamada S, Kamiyama Y, Takeishi Y. Efficacy of intrathoracic impedance and remote monitoring in patients with an implantable device after the 2011 great East Japan earthquake. Int Heart J 2014; 55:53-7. [PMID: 24463930 DOI: 10.1536/ihj.13-215] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Several studies have revealed that stress after catastrophic disasters can trigger cardiovascular events, however, little is known about its association with the occurrence of heart failure in past earthquakes. The objective of the present study was to determine whether the Great East Japan Earthquake on March 11, 2011, increased the incidence of worsening heart failure in chronic heart failure (CHF) patients with implantable devices. Furthermore, we examined whether intrathoracic impedance using remote monitoring was effective for the management of CHF.We enrolled 44 CHF patients (32 males, mean age 63 ± 12 years) with implantable devices that can check intrathoracic impedance using remote monitoring. We defined the worsening heart failure as accumulated impedance under reference impedance exceeding 60 ohms-days (fluid index threshold), and compared the incidence of worsening heart failure and arrhythmic events 30 days before and after March 11.Within the 30 days after March 11, 10 patients exceeded the threshold compared with only 2 patients in the preceding 30 days (P < 0.05). Although 9 patients using remote monitoring among the 10 patients with threshold crossings were not hospitalized, one patient without the system was hospitalized due to acute decompensated heart failure. On the contrary, arrhythmic events did not change between before and after March 11.Our results suggest that earthquake-induced stress causes an increased risk of worsening heart failure without changes in arrhythmia. Furthermore, intrathoracic impedance using remote monitoring may be a useful tool for the management of CHF in catastrophic disasters.
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Affiliation(s)
- Hitoshi Suzuki
- Department of Arrhythmia and Cardiac Pacing, Fukushima Medical University
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Striuli R, Petrazzi L, Giorgini P, Petrarca M, Pantoli F, Polidoro L, Properzi G, Pasqualetti P, Desideri G, Ferri C, Parati G. Changes in 24-h ambulatory blood pressure during the 2009 earthquake at L'Aquila: a new evaluation in the same patients. Intern Med J 2013; 43:348-9. [PMID: 23441667 DOI: 10.1111/imj.12072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Accepted: 09/23/2012] [Indexed: 11/29/2022]
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Blood pressure elevation in hemodialysis patients after the Great East Japan Earthquake. Hypertens Res 2013; 37:139-44. [DOI: 10.1038/hr.2013.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2012] [Revised: 05/21/2013] [Accepted: 07/06/2013] [Indexed: 11/08/2022]
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Chan C, Elliott J, Troughton R, Frampton C, Smyth D, Crozier I, Bridgman P. Acute myocardial infarction and stress cardiomyopathy following the Christchurch earthquakes. PLoS One 2013; 8:e68504. [PMID: 23844213 PMCID: PMC3699519 DOI: 10.1371/journal.pone.0068504] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 05/30/2013] [Indexed: 11/18/2022] Open
Abstract
Background Christchurch, New Zealand, was struck by 2 major earthquakes at 4:36am on 4 September 2010, magnitude 7.1 and at 12:51pm on 22 February 2011, magnitude 6.3. Both events caused widespread destruction. Christchurch Hospital was the region's only acute care hospital. It remained functional following both earthquakes. We were able to examine the effects of the 2 earthquakes on acute cardiac presentations. Methods Patients admitted under Cardiology in Christchurch Hospital 3 week prior to and 5 weeks following both earthquakes were analysed, with corresponding control periods in September 2009 and February 2010. Patients were categorised based on diagnosis: ST elevation myocardial infarction, Non ST elevation myocardial infarction, stress cardiomyopathy, unstable angina, stable angina, non cardiac chest pain, arrhythmia and others. Results There was a significant increase in overall admissions (p<0.003), ST elevation myocardial infarction (p<0.016), and non cardiac chest pain (p<0.022) in the first 2 weeks following the early morning September earthquake. This pattern was not seen after the early afternoon February earthquake. Instead, there was a very large number of stress cardiomyopathy admissions with 21 cases (95% CI 2.6–6.4) in 4 days. There had been 6 stress cardiomyopathy cases after the first earthquake (95% CI 0.44–2.62). Statistical analysis showed this to be a significant difference between the earthquakes (p<0.05). Conclusion The early morning September earthquake triggered a large increase in ST elevation myocardial infarction and a few stress cardiomyopathy cases. The early afternoon February earthquake caused significantly more stress cardiomyopathy. Two major earthquakes occurring at different times of day differed in their effect on acute cardiac events.
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Affiliation(s)
- Christina Chan
- Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand.
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81
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Abstract
Functional integrity of endothelial cells is an indicator and a prerequisite for vascular health and counteracts the development of atherosclerosis. This concept of 'endothelial therapy' was developed in the late 1990s as an approach to preserve or restore endothelial cell health given that 'the knowledge of the mechanisms involved in 'endothelial dysfunction' allows us to interfere specifically with pathogenic pathways at very early time points and to slow down the progression of disease'. In the present review, the principles underlying endothelial cell health will be discussed as well as the role of endothelial therapy as a preventive measure to reduce the prevalence of coronary artery disease or to delay disease progression in patients with chronic coronary artery disease. This article also highlights the importance of active participation, the need to reduce the number of future patients in view of the rising prevalence of childhood obesity, and the potential of endothelial therapy to improve survival, reduce disability and health costs, and to improve overall quality of life in patients at risk for or already diagnosed with coronary artery disease. The preventive and therapeutic approaches and considerations described herein can be applied by physicians, patients, parents, educators, health agencies, and political decision makers to help reducing the global cardiovascular disease burden in the decades to come.
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Affiliation(s)
- Matthias Barton
- Molecular Internal Medicine, University of Zürich, LTK Y44 G22, Winterthurerstrasse 190, 8057 Zürich, Switzerland.
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Murakami H, Akashi H, Noda S, Mizoue T, Okazaki O, Ouchi Y, Okaji Y, Kajiwara C, Miyoshi C. A cross-sectional survey of blood pressure of a coastal city's resident victims of the 2011 Tohoku tsunami. Am J Hypertens 2013; 26:799-807. [PMID: 23455946 DOI: 10.1093/ajh/hpt022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Blood pressure (BP) increase as a reaction to major disasters has been well documented; however, the impact has been underdocumented for tsunamis. This study aimed to confirm whether different levels of flooding/inundation and other damage caused by the 2011 Tohoku (northeast Japan) tsunami were associated with BP among resident victims in Higashi-Matsushima, Miyagi. METHODS Cross-sectional household screening was conducted 7-19 weeks after the disaster in administrative areas totally or partially flooded by the tsunami. Systolic and diastolic BP (SBP/DBP) were measured in 4,311 residents. RESULTS There was a degree-dependent association between SBP/DBP and flooding height above sea level among victims not on antihypertensive medication (P < 0.01 for both). Disruption of the gas supply was also significantly associated with SBP/DBP (P < 0.01 for both). Among individuals on antihypertensive medication, the discontinuation of medication was associated with SBP/DBP (P < 0.01 for both). After adjusting for confounding and multiplicity, a matched case-control analysis did not identify any significant associations between the tsunami or lifeline indicators and high BP (SBP ≥160mm Hg or DBP ≥100mm Hg). CONCLUSIONS This study suggests that after a major tsunami, resident victims in areas highly inundated by flood waters and those with disrupted gas supply are more likely to have higher BP and thus might warrant getting BP screening earlier than other residents. Those with hypertension should be given assistance to resume or commence antihypertensive medication as soon as possible to reduce the risk of cardiovascular morbidity and mortality.
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Affiliation(s)
- Hitoshi Murakami
- Bureau of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
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Hung KKC, Lam ECC, Chan EYY, Graham CA. Disease pattern and chronic illness in rural China: the Hong Kong Red Cross basic health clinic after 2008 Sichuan earthquake. Emerg Med Australas 2013; 25:252-9. [PMID: 23759047 DOI: 10.1111/1742-6723.12080] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Medical teams might have difficulties preparing for deployment to rural towns due to a lack of prior information. The study objective was to identify the health needs and chronic disease prevalence of rural Chinese following a major earthquake. METHODS Hong Kong Red Cross organised a basic healthcare team to Yanmen town, Jiangyou 3 weeks after the 2008 Sichuan earthquake. A cross-sectional records-based study of all patients treated by the Hong Kong Red Cross basic healthcare team from 1 June to 19 June 2008 was conducted. RESULTS Two thousand and thirty-four individual patient encounters occurred during the 19-day period. Musculoskeletal, respiratory and gastrointestinal problems were the top three categories and accounted for 30.4%, 17.4% and 12.7%, respectively. The 43.4% of the 762 patients with blood pressure measurements were above the recognised criteria for hypertension. CONCLUSIONS We identified that the management of chronic diseases was an important issue, especially with the high prevalence of hypertension found in our study. Medical responders need to be aware of the potential pre-existing disease burden in the community, with the possible exacerbation in post-disaster situations. Careful planning on the use of treatment guidelines with particular focus on the local health resources available and issues with continuation of care will provide better care for the patients.
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Affiliation(s)
- Kevin K C Hung
- Collaborating Centre for Oxford University and CUHK for Disaster and Medical Humanitarian Response, School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China.
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Patel HM, Mast JL, Sinoway LI, Muller MD. Effect of healthy aging on renal vascular responses to local cooling and apnea. J Appl Physiol (1985) 2013; 115:90-6. [PMID: 23640587 DOI: 10.1152/japplphysiol.00089.2013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sympathetically mediated renal vasoconstriction may contribute to the pathogenesis of hypertension in older adults, but empirical data in support of this concept are lacking. In 10 young (26 ± 1 yr) and 11 older (67 ± 2 yr) subjects, we quantified acute hemodynamic responses to three sympathoexcitatory stimuli: local cooling of the forehead, cold pressor test (CPT), and voluntary apnea. We hypothesized that all stimuli would increase mean arterial blood pressure (MAP) and renal vascular resistance index (RVRI) and that aging would augment these effects. Beat-by-beat MAP, heart rate (HR), and renal blood flow velocity (from Doppler) were measured in the supine posture, and changes from baseline were compared between groups. In response to 1°C forehead cooling, aging was associated with an augmented MAP (20 ± 3 vs. 6 ± 2 mmHg) and RVRI (35 ± 6 vs. 16 ± 9%) but not HR. In older adults, there was a positive correlation between the cold-induced pressor response and forehead pain (R = 0.726), but this effect was not observed in young subjects. The CPT raised RVRI in both young (56 ± 13%) and older (45 ± 8%) subjects, but this was not different between groups. Relative to baseline, end-expiratory apnea increased RVRI to a similar extent in both young (46 ± 14%) and older (41 ± 9%) subjects. During sympathetic activation, renal vasoconstriction occurred in both groups. Forehead cooling caused an augmented pressor response in older adults that was related to pain perception.
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Affiliation(s)
- Hardikkumar M Patel
- Pennsylvania State University College of Medicine, Penn State Hershey Heart and Vascular Institute, Hershey, PA 17033, USA
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Long-term blood pressure changes induced by the 2009 L'Aquila earthquake: assessment by 24 h ambulatory monitoring. Hypertens Res 2013; 36:795-8. [PMID: 23595046 DOI: 10.1038/hr.2013.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Revised: 01/21/2013] [Accepted: 01/23/2013] [Indexed: 02/08/2023]
Abstract
An increased rate of cardiovascular and cerebrovascular events has been described during and immediately after earthquakes. In this regard, few data are available on long-term blood pressure control in hypertensive outpatients after an earthquake. We evaluated the long-term effects of the April 2009 L'Aquila earthquake on blood pressure levels, as detected by 24 h ambulatory blood pressure monitoring. Before/after (mean±s.d. 6.9±4.5/14.2±5.1 months, respectively) the earthquake, the available 24 h ambulatory blood pressure monitoring data for the same patients were extracted from our database. Quake-related daily life discomforts were evaluated through interviews. We enrolled 47 patients (25 female, age 52±14 years), divided into three groups according to antihypertensive therapy changes after versus before the earthquake: unchanged therapy (n=24), increased therapy (n=17) and reduced therapy (n=6). Compared with before the quake, in the unchanged therapy group marked increases in 24 h (P=0.004), daytime (P=0.01) and nighttime (P=0.02) systolic blood pressure were observed after the quake. Corresponding changes in 24 h (P=0.005), daytime (P=0.01) and nighttime (P=0.009) diastolic blood pressure were observed. Daily life discomforts were reported more frequently in the unchanged therapy and increased therapy groups than the reduced therapy group (P=0.025 and P=0.018, respectively). In conclusion, this study shows that patients with unchanged therapy display marked blood pressure increments up to more than 1 year after an earthquake, as well as long-term quake-related discomfort. Our data suggest that particular attention to blood pressure levels and adequate therapy modifications should be considered after an earthquake, not only early after the event but also months later.
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Zoladz PR, Diamond DM. Current status on behavioral and biological markers of PTSD: a search for clarity in a conflicting literature. Neurosci Biobehav Rev 2013; 37:860-95. [PMID: 23567521 DOI: 10.1016/j.neubiorev.2013.03.024] [Citation(s) in RCA: 188] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 03/23/2013] [Accepted: 03/27/2013] [Indexed: 12/24/2022]
Abstract
Extensive research has identified stereotypic behavioral and biological abnormalities in post-traumatic stress disorder (PTSD), such as heightened autonomic activity, an exaggerated startle response, reduced basal cortisol levels and cognitive impairments. We have reviewed primary research in this area, noting that factors involved in the susceptibility and expression of PTSD symptoms are more complex and heterogeneous than is commonly stated, with extensive findings which are inconsistent with the stereotypic behavioral and biological profile of the PTSD patient. A thorough assessment of the literature indicates that interactions among myriad susceptibility factors, including social support, early life stress, sex, age, peri- and post-traumatic dissociation, cognitive appraisal of trauma, neuroendocrine abnormalities and gene polymorphisms, in conjunction with the inconsistent expression of the disorder across studies, confounds attempts to characterize PTSD as a monolithic disorder. Overall, our assessment of the literature addresses the great challenge in developing a behavioral and biomarker-based diagnosis of PTSD.
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Affiliation(s)
- Phillip R Zoladz
- Department of Psychology, Sociology, & Criminal Justice, Ohio Northern University, 525 S. Main St., Ada, OH, 45810, USA
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Omote S, Kato M, Kido T, Okamoto R, Ichimori A, Sakakibara C, Tsukasaki K. Relationship between the degree of property damage and changes in red blood cells, hematocrit, and hemoglobin among victims of the Noto Peninsula Earthquake. Environ Health Prev Med 2013; 18:151-64. [PMID: 23132633 PMCID: PMC3590323 DOI: 10.1007/s12199-012-0305-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 08/31/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the impact of the Noto Peninsula Earthquake on various hematologic parameters. We studied the relationships between the degree of property damage and changes in red blood cells (RBCs), hemoglobin (Hb), and hematocrit (Ht) among residents before and after the March 2007 Noto Peninsula Earthquake. METHODS A total of 5,563 residents of Wajima City who were not receiving oral treatment for anemia and who had received basic health screenings for fiscal years (FYs) 2006 and 2007, before and after the earthquake. We analyzed changes in their RBCs, Hb, and Ht levels by gender, age, body mass index (BMI), level of property damage, and evaluation standards. RESULTS RBCs, Hb, and Ht for FY2007 showed a trend of decreasing values compared to FY2006 in both male and female subjects. RBCs and Hb significantly decreased in females aged between 65 and 74 years who experienced total property damage, and Ht significantly increased for those younger than 65 years who experienced the same level of damage. In addition, significant differences by degree of property damage and FY2007/FY2006 ratio were seen only among subjects with a BMI ratio <1. Furthermore, we found a significant relationship between reduction of RBCs or Hb and increasing age in females; however, no significant relationship to property damage was found. No significant relationships were found for males. CONCLUSIONS A significant association between property damage and changes in RBCs, Hb, and Ht was not found in this population of residents who experienced the Noto Peninsula Earthquake.
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Affiliation(s)
- Shizuko Omote
- Division of Nursing, Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa 920-0942, Japan.
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88
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Ribeiro AI, de Fátima de Pina M. Could moderate earthquakes also trigger cardiac events? Eur J Epidemiol 2013; 28:199-202. [DOI: 10.1007/s10654-013-9779-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 02/05/2013] [Indexed: 10/27/2022]
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89
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Fukagawa M, Kim JI, Fujii H. Another role for nephrologists in disaster medicine. Clin Exp Nephrol 2013; 17:153-4. [PMID: 23385779 DOI: 10.1007/s10157-013-0773-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 01/07/2013] [Indexed: 11/26/2022]
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90
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Shimizu K, Takahashi M, Shirai K. A Huge Earthquake Hardened Arterial Stiffness Monitored with Cardio-Ankle Vascular Index. J Atheroscler Thromb 2013; 20:503-11. [DOI: 10.5551/jat.16097] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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91
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Lifetime trauma exposure and prospective cardiovascular events and all-cause mortality: findings from the Heart and Soul Study. Psychosom Med 2013; 75:849-55. [PMID: 24149074 PMCID: PMC4014357 DOI: 10.1097/psy.0b013e3182a88846] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Little is known about the effect of cumulative psychological trauma on health outcomes in patients with cardiovascular disease. The objective of this study was to prospectively examine the association between lifetime trauma exposure and recurrent cardiovascular events or all-cause mortality in patients with existing cardiovascular disease. METHODS A total of 1021 men and women with cardiovascular disease were recruited in 2000 to 2002 and followed annually. Trauma history and psychiatric comorbidities were assessed at baseline using the Computerized Diagnostic Interview Schedule for DSM-IV. Health behaviors were assessed using standardized questionnaires. Outcome data were collected annually, and all medical records were reviewed by two independent, blinded physician adjudicators. We used Cox proportional hazards models to evaluate the association between lifetime trauma exposure and the composite outcome of cardiovascular events and all-cause mortality. RESULTS During an average of 7.5 years of follow-up, there were 503 cardiovascular events and deaths. Compared with the 251 participants in the lowest trauma exposure quartile, the 256 participants in the highest exposure quartile had a 38% greater risk of adverse outcomes (hazard ratio = 1.38, 95% confidence interval = 1.06-1.81), adjusted for age, sex, race, income, education, depression, posttraumatic stress disorder, generalized anxiety disorder, smoking, physical inactivity, and illicit drug abuse. CONCLUSIONS Cumulative exposure to psychological trauma was associated with an increased risk of recurrent cardiovascular events and mortality, independent of psychiatric comorbidities and health behaviors. These data add to a growing literature showing enduring effects of repeated trauma exposure on health that are independent of trauma-related psychiatric disorders such as depression and posttraumatic stress disorder.
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92
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Nozaki E, Nakamura A, Abe A, Kagaya Y, Kohzu K, Sato K, Nakajima S, Fukui S, Endo H, Takahashi T, Seki H, Tamaki K, Mochizuki I. Occurrence of Cardiovascular Events After the 2011 Great East Japan Earthquake and Tsunami Disaster. Int Heart J 2013; 54:247-53. [DOI: 10.1536/ihj.54.247] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Eiji Nozaki
- Department of Cardiology, Iwate Prefectural Central Hospital
| | | | - Akiyo Abe
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Yuta Kagaya
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Katsuya Kohzu
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Kenjiro Sato
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Souta Nakajima
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Sigefumi Fukui
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Hideaki Endo
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Tohru Takahashi
- Department of Cardiology, Iwate Prefectural Central Hospital
| | - Hirofumi Seki
- Department of Neurosurgery, Iwate Prefectural Central Hospital
| | - Kenji Tamaki
- Department of Cardiology, Iwate Prefectural Miyako Hospital
| | - Izumi Mochizuki
- Department of Gastroenterological Surgery, Iwate Prefectural Central Hospital
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93
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Forouzanfar MH, Moran AE, Flaxman AD, Roth G, Mensah GA, Ezzati M, Naghavi M, Murray CJL. Assessing the global burden of ischemic heart disease, part 2: analytic methods and estimates of the global epidemiology of ischemic heart disease in 2010. Glob Heart 2012; 7:331-342. [PMID: 23505617 DOI: 10.1016/j.gheart.2012.10.003] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Ischemic Heart Disease (IHD) is the leading cause of death worldwide. The Global Burden of Diseases, Injuries and Risk Factors (GBD) 2010 Study estimated IHD mortality and disability burden for 21 world regions for the years 1990 to 2010. METHODS Data sources for GBD IHD epidemiology estimates were mortality surveillance, verbal autopsy, and vital registration data (for IHD mortality) and systematic review of IHD epidemiology literature published 1980-2008 (for non-fatal IHD outcomes). An estimation and validation process led to an ensemble model of IHD mortality by country for all 21 world regions, adjusted for country-level covariates. Disease models were developed for the nonfatal sequelae of IHD: myocardial infarction, stable angina pectoris, and ischemic heart failure. RESULTS Country level covariates including metabolic and nutritional risk factors, education, war, and annual income per capita contributed to the ensemble model for the analysis of IHD death. In the acute myocardial infarction model, inclusion of troponin in the diagnostic criteria of studies published after the year 2000 was associated with a 50% higher incidence. Self-reported diagnosis of angina significantly overestimated stable angina prevalence compared with "definite" angina elicited by the Rose angina questionnaire. For 2010, Eastern Europe and Central Asia had the highest rates of IHD death and the Asia Pacific High-Income, East Asia, Latin American Andean, and sub-Saharan Africa regions had the lowest. CONCLUSIONS Global and regional IHD epidemiology estimates are needed for estimating the worldwide burden of IHD. Using descriptive meta-analysis tools, the GBD 2010 standardized and pooled international data by adjusting for region-level mortality and risk factor data, and study level diagnostic method. Analyses maximized internal consistency, generalizability, and adjustment for known sources of bias. The GBD IHD analysis nonetheless highlights the need for improved IHD epidemiology surveillance in many regions and the need for uniform diagnostic standards.
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94
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Moghimian M, Faghihi M, Karimian SM, Imani A, Houshmand F, Azizi Y. Role of central oxytocin in stress-induced cardioprotection in ischemic-reperfused heart model. J Cardiol 2012; 61:79-86. [PMID: 23159205 DOI: 10.1016/j.jjcc.2012.08.021] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Revised: 06/23/2012] [Accepted: 08/06/2012] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND PURPOSE There is growing evidence that stress contributes to cardiovascular disease and triggers the release of oxytocin. Moreover previous studies confirmed oxytocin mimics the protection associated with ischemic preconditioning. The present study was aimed to assess the possible cardioprotective effects of the centrally released oxytocin in response to stress and intracerebroventricular (i.c.v.) administration of exogenous oxytocin in ischemic-reperfused isolated rat heart. METHODS AND SUBJECTS Rats were divided in two main groups and all of them were subjected to i.c.v. infusion of vehicle or drugs: unstressed rats [control: vehicle, oxytocin (OT; 100 ng/5 μl), atosiban (ATO; 4.3 μg/5 μl) as oxytocin antagonist, ATO+OT] and stressed rats [St: stress, OT+St, ATO+St]. After anesthesia, hearts were isolated and subjected to 30 min regional ischemia and 60 min reperfusion (IR). Acute stress protocol included swimming for 10 min before anesthesia. Myocardial function, infarct size, coronary flow, ventricular arrhythmia, and biochemical parameters such as creatine kinase and lactate dehydrogenase were measured. Ischemia-induced ventricular arrhythmias were counted during the occlusion period. RESULTS The plasma levels of oxytocin and corticosterone were significantly elevated by stress. Unexpectedly hearts of stressed rats showed a marked depression of IR injury compared to control group. I.c.v. infusion of oxytocin mimicked the cardioprotective effects of stress, yet did not elevate plasma oxytocin level. The protective effects of both stress and i.c.v. oxytocin were blocked by i.c.v. oxytocin antagonist. CONCLUSIONS These findings suggest that i.c.v. infusion of exogenous oxytocin and centrally released endogenous oxytocin in response to stress could play a role in induction of a preconditioning effect in ischemic-reperfused rat heart via brain receptors.
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Affiliation(s)
- Maryam Moghimian
- Department of Physiology, School of Medicine, Gonabad University of Medical Science, Gonabad, Islamic Republic of Iran
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Moghimian M, Faghihi M, Karimian SM, Imani A. The effect of acute stress exposure on ischemia and reperfusion injury in rat heart: role of oxytocin. Stress 2012; 15:385-92. [PMID: 22044052 DOI: 10.3109/10253890.2011.630436] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Previous studies showed the protective effects of oxytocin (OT) on myocardial injury in ischemic and reperfused rat heart. Moreover, exposure to various stressors not only evokes sudden cardiovascular effects but also triggers the release of OT in the rat. The present study was aimed to evaluate the possible cardioprotective effects of endogenous OT released in response to stress (St), and effects of administration of exogenous OT on the ischemic-reperfused isolated heart of rats previously exposed to St. Wistar rats were divided into six groups: ischemia/reperfusion (IR); St: rats exposed to swim St for 10 min before anesthesia; St+atosiban (ATO): an OT receptor antagonist, was administered (1.5 mg/kg i.p.) prior to St; St+OT: OT was administered (0.03 mg/kg i.p.) prior to St; OT: OT was administrated prior to anesthesia; ATO was given prior to anesthesia. Isolated hearts were perfused with Krebs buffer solution by the Langendorff method and subjected to 30 min of regional ischemia followed by 60 min of reperfusion. The infarct size (IS) and creatine kinase MB isoenzyme (CK-MB) and lactate dehydrogenase (LDH) in coronary effluent were measured. Hemodynamic parameters were recorded throughout the experiment. The plasma concentrations of OT and corticosterone were significantly increased by St. Unexpectedly St decreased IR injury compared with the IR alone group. OT administration significantly inhibited myocardial injury, and administration of ATO with St abolished recovery of the rate pressure product, and increased IS and levels of CK-MB and LDH. These findings indicate that activation of cardiac OT receptors by OT released in response to St may participate in cardioprotection and inhibition of myocardial IR injury.
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Affiliation(s)
- Maryam Moghimian
- Department of physiology, School of Medicine, Tehran University of Medical Science, Tehran, Islamic Republic of Iran
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96
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Injuries and Illnesses Treated at the World Trade Center, 14 September–20 November 2001. Prehosp Disaster Med 2012. [DOI: 10.1017/s1049023x00002417] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractIntroduction:In response to the 11 September 2001 terrorist attacks on the World Trade Center (WTC), the United States Public Health Service (USPHS) deployed Disaster Medical Assistance Teams (DMATs) and the Commissioned Corps to provide on-site, primary medical care to anyone who presented. Patients included rescue and recovery workers, other responders, and some members of the general public.Objective:A descriptive analysis of WTC-USPHS patient records was conducted in order to better understandthe short-term impact of the WTC site on the safety and health of individuals who were at or near the site from 14 September–20 November 2001.Methods:The Patient Treatment Record forms that were completed for each patient visit to these USPHS stations over the 10-week deployment period were reviewed.Results:Patient visits numbered 9,349, with visits peaking during Week 2 (21–27 September). More than one-quarter of the visits were due to traumatic injuries not including eye injuries (n = 2,716; 29%). Respiratory problems comprised more than one-fifth of the complaints (n = 2,011; 22%). Eye problems were the third most frequent complaint (n = 1,120; 12%). With respect to the triage class, the majority of visits fell into the lowest category of severity (n = 6,237; 67%).Conclusion:USPHS visits probably were skewed to milder complaints when compared to analyses of employer medical department reports or hospital cases; however, given the close proximity of the USPHS stations to the damage, analysis of the USPHS forms provides a more complete picture of the safety and health impact on those who were at or near the WTC site.
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Abstract
AbstractMitigating disaster impact requires identifying risk factors. The increased vulnerability of the physically fragile is easily understood. Less obvious are the socio-economic risk factors, especially within relatively affluent societies. Hurricane Katrina demonstrated many of these risks within the United States.These factors include poverty, home ownership, poor English language proficiency, ethnic minorities, immigrant status, and high-density housing. These risk factors must be considered when planning for disaster preparation, mitigation, and response.
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Abstract
Major earthquakes are some of the most devastating natural disasters. The epidemiology of earthquake-related injuries and mortality is unique for these disasters. Because earthquakes frequently affect populous urban areas with poor structural standards, they often result in high death rates and mass casualties with many traumatic injuries. These injuries are highly mechanical and often multisystem, requiring intensive curative medical and surgical care at a time when the local and regional medical response capacities have been at least partly disrupted. Many patients surviving blunt and penetrating trauma and crush injuries have subsequent complications that lead to additional morbidity and mortality. Here, we review and summarise earthquake-induced injuries and medical complications affecting major organ systems.
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Affiliation(s)
- Susan A Bartels
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
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Abstract
The devastating Great East Japan Earthquake, which was 9.0 on the Richter scale, occurred on March 11, 2011. Japan experienced the Great Hanshin-Awaji Earthquake 16 years ago, and I was working at the epicenter, and reported the characteristics of the earthquake-associated cardiovascular risk and high blood pressure (BP) found during the continuous practice and clinical studies of Tsuna Medical Association before and after the quake. A major disaster increases thrombophilic tendency and BP, both of which trigger disaster-induced cardiovascular events such as stroke, cardiac events, etc. The high salt intake and the increased salt sensitivity caused by disrupted circadian rhythms are the 2 major leading causes of disaster hypertension (HT) through neurohumoral activation under stressful conditions. To better assess and reduce the risks for disaster-associated cardiovascular events, we introduced the web-based Disaster Cardiovascular Prevention (DCAP) network (which consists of DCAP risk and prevention score assessment, and self-measured BP monitoring at both the shelter and the home) to the survivors of the 2011 disaster, and frequently found newly developed HT. Here I review the recent evidence, possible mechanism and the management of "disaster HT" for effective prevention of disaster-induced cardiovascular events.
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Affiliation(s)
- Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, and Department of Sleep and Circadian Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan.
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Ogawa S, Ishiki M, Nako K, Okamura M, Senda M, Sakamoto T, Ito S. Effects of the Great East Japan Earthquake and huge tsunami on glycaemic control and blood pressure in patients with diabetes mellitus. BMJ Open 2012; 2:e000830. [PMID: 22505311 PMCID: PMC3332258 DOI: 10.1136/bmjopen-2012-000830] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To examine the effects of a huge tsunami resulting from the Great East Japan Earthquake on blood pressure (BP) control and glycaemic control in diabetic patients. DESIGN A retrospective study. SETTING Tohoku University, Japan. PARTICIPANTS 63 patients were visiting Rikuzentakata Hospital for diabetic treatment before the earthquake and returned to the clinic in July after the earthquake, and they were analysed in the present study. The subjects were divided into two groups: those who were hit by the tsunami, the Tsunami (+) group (n=28), and those who were not, the Tsunami (-) group (n=35), and the groups' parameters and their changes were compared. PRIMARY OUTCOME MEASURE Changes of HbA1c. SECONDARY OUTCOME MEASURES Changes of BP, body mass index. RESULTS HbA1c and both BP increased, while the numbers of most drugs taken decreased in both groups. Parameter changes were significantly greater in the Tsunami (+) group. All medical data stored at the hospital was lost in the tsunami. The Tsunami (+) patients also had their own records of treatment washed away, so it was difficult to replicate their pre-earthquake drug prescriptions afterwards. In comparison, the Tsunami (-) patients kept their treatment information, making it possible to resume the treatment they had been receiving before the earthquake. The BP rose only slightly in men, whereas it rose sharply in women, even though they had not been directly affected by the tsunami. BP rose markedly in both genders affected by the tsunami. CONCLUSIONS All medical information was lost in the tsunami, and glycaemic and BP controls of the tsunami-affected patients worsened more than those of patients who had been affected by the earthquake alone. Women may be more sensitive to changes in the living environment that result from a major earthquake than are men.
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Affiliation(s)
- Susumu Ogawa
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
- Center for the Advancement of Higher Education, Tohoku University, Sendai, Japan
| | | | - Kazuhiro Nako
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
| | - Masashi Okamura
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
- Center for Translational and Advanced Research, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miho Senda
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
| | - Takuya Sakamoto
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
| | - Sadayoshi Ito
- Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan
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