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Shibata S, Hoshide S. Current situation of telemedicine research for cardiovascular risk in Japan. Hypertens Res 2023; 46:1171-1180. [PMID: 36849580 PMCID: PMC9969376 DOI: 10.1038/s41440-023-01224-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 03/01/2023]
Abstract
Hypertension continues to be a principal risk factor for the occurrence of cardiovascular disorders, stroke, and kidney diseases. Although more than 40 million subjects suffer from hypertension in Japan, its optimal control is achieved only a subpopulation of patients, highlighting the need for novel approaches to manage this disorder. Toward the better control of blood pressure, the Japanese Society of Hypertension has developed the Future Plan, in which the application of the state-of-art information and communication technology, including web-based resources, artificial intelligence, and big data analysis, is considered as one of the promising solutions. In fact, the rapid advance of digital health technologies, as well as ongoing coronavirus disease 2019 pandemic, has triggered the structural changes in the healthcare system globally, increasing demand for the remote delivery of the medical services. Nonetheless, it is not entirely clear what evidence exists that support the widespread use of telemedicine in Japan. Here, we summarize the current status of telemedicine research, particularly in the field of hypertension and other cardiovascular risk factors. We note that there have been very few interventional studies in Japan that clearly showed the superiority or noninferiority of telemedicine over standard care, and that the methods of online consultation considerably varied among studies. Clearly, more evidence is necessary for wide implementation of telemedicine in hypertensive patients in Japan, and also those with other cardiovascular risk factors.
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Affiliation(s)
- Shigeru Shibata
- Division of Nephrology, Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
| | - Satoshi Hoshide
- grid.410804.90000000123090000Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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2
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A systematic review of effective strategies for chronic disease management in humanitarian settings; opportunities and challenges. Prev Med 2022; 161:107154. [PMID: 35817161 DOI: 10.1016/j.ypmed.2022.107154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/29/2022] [Accepted: 07/05/2022] [Indexed: 11/22/2022]
Abstract
Large number of people with non-communicable diseases (NCDs) face barriers to adequate healthcare in humanitarian settings. We conducted a systematic literature review in MEDLINE/PubMed, Web of Science, EMBASE/DARE, Cochrane, and grey literature from 1990 to 2021 to evaluate effective strategies in addressing NCDs (diabetes, cardiovascular diseases, COPD, cancer) in humanitarian settings. From 2793 articles, 2652 were eliminated through title/abstract screening; 141 articles were reviewed in full; 93 were eliminated for not meeting full criteria. Remaining 48 articles were reviewed qualitatively to assess populations, settings, interventions, outcome, and efficacy and effectiveness; 38 studies addressed treatments, 9 prevention, and 7 epidemiology. Prevention studies broadly addressed capacity-building. Treatment and epidemiology studies largely addressed hypertension and diabetes. Interventions included web-based/mobile health strategies, pharmacy-level interventions, portable imaging, and capacity building including physical clinics, staff training, forging collaborations, guideline development, point-of-care labs, health promotion activities, EMR, and monitoring interventions. Collaboration between academia and implementing agencies was limited. Models of care were largely not well-described and varied between studies due to contextual constraints. Barriers to interventions included financial, logistical, organizational, sociocultural, and security. Cancer care is significantly understudied. Simplified care models adapted to contexts and program evaluations of implemented strategies could address gaps in applied research. Inherent challenges in humanitarian settings pose unavoidable perils to evidence generation which requires a shift in research mindset to match aspirations with practicality, research collaborations at the inception of projects, reworking of desired conventional level of research evidence considering resource-intense constraints (HR, time, cost), and adapted research tools, methods, and procedures.
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3
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Sunohara D, Miura T, Komatsu T, Hashizume N, Momose T, Kono T, Motoki H, Mochidome T, Kasai T, Kuwahara K, Ikeda U. Relationship between the flood disaster caused by the Reiwa first year east Japan typhoon and cardiovascular and cerebrovascular events in Nagano City: The SAVE trial. J Cardiol 2021; 78:447-455. [PMID: 34183228 DOI: 10.1016/j.jjcc.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/15/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND The Reiwa First Year East Japan Typhoon of 2019 caused a torrential flood in Japan. In Nagano City, a large area was flooded due to the collapse of the Chikuma River embankment. After large-scale disasters, an increase in cardiovascular and cerebrovascular events has been reported on account of the stressful conditions. However, few reports of disaster-related diseases associated with flood damage have been described. Thus, our aim was to elucidate the effect of floods on the incidences of cardiovascular and cerebrovascular diseases in Nagano City. METHODS The Shinshu Assessment of Flood Disaster Cardiovascular Events (SAVE) trial enrolled 2,426 patients admitted for cardiovascular or cerebrovascular diseases at all five hospitals with an emergency department in Nagano City from October 1 to December 31 in the years 2017, 2018, and 2019. The occurrence of these diseases was calculated in every 2 weeks and the findings of 2019 (year of the flood) were compared with those of 2017 and 2018. RESULTS Cardiovascular and cerebrovascular diseases significantly increased during the 2 weeks immediately after the flood disaster (149 in 2019 vs average of 116.5 in the previous 2 years, p < 0.05). Unstable angina cases significantly increased 1.5-2 months after the flood disaster, and cerebral hemorrhage cases significantly increased in the 2 weeks after the flood disaster. CONCLUSIONS Cardiovascular and cerebrovascular events increased significantly during the 2 weeks immediately after the large-scale flood disaster caused by the Reiwa First Year East Japan typhoon. Because of the increasing frequency of flood disasters, it is necessary to predict the occurrences of cardiovascular and cerebrovascular diseases and to implement guidelines for their appropriate and timely management.
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Affiliation(s)
| | - Takashi Miura
- Cardiology, Nagano Municipal Hospital, Nagano, Japan; Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | | | | | - Tomoyasu Momose
- Cardiology, Nagano Matsushiro General Hospital, Nagano, Japan
| | | | - Hirohiko Motoki
- Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | | | - Toshio Kasai
- Cardiology, Nagano Municipal Hospital, Nagano, Japan
| | - Koichiro Kuwahara
- Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
| | - Uichi Ikeda
- Cardiology, Nagano Municipal Hospital, Nagano, Japan; Cardiovascular Medicine, Shinshu University School of Medicine, Nagano, Japan
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Medical Problems and Concerns with Temporary Evacuation Shelters after Great Earthquake Disasters in Japan: A Systematic Review. Disaster Med Public Health Prep 2021; 16:1645-1652. [PMID: 34103106 DOI: 10.1017/dmp.2021.99] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Japan has repeatedly suffered from natural disasters. A number of temporary evacuation shelters have been opened for the benefit of evacuees. Although the operation of such evacuation shelters has improved after the Great Hanshin-Awaji Earthquake (1995), a number of operational difficulties were encountered during the Great East Japan Earthquake in 2011 and the Kumamoto Earthquake in 2016. A systematic literature review was conducted to identify the medical concerns encountered in temporary evacuation shelters by focusing on unsanitary environment, food and nutrition, and shortage of medication. Actual sanitary conditions have been found to be below the standards stipulated by the Japanese government as per international guidelines. Food aid in evacuation shelters was neither nutritionally balanced, nor was the distribution to different shelters balanced. Furthermore, evacuees with chronic diseases feared that there may be a shortage of medication. Crowding in evacuation shelters increased the risk of outbreaks of infectious diseases (e.g., tuberculosis). Malnutrition and shortage of medication exacerbated the risk of deterioration of chronic diseases (e.g., diabetes mellitus, hypertension) among evacuees. Therefore, it is recommended that healthcare professionals should be promptly deployed to evacuation shelters, to promote sanitary control and education, as well as address limited space availability, and food and medication shortage.
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Medved S, Imširagić AS, Salopek I, Puljić D, Handl H, Kovač M, Peleš AM, Štimac Grbic D, Romančuk L, MuŽić R, Zeeman LS, Kuzman MR. Case Series: Managing Severe Mental Illness in Disaster Situation: the Croatian Experience After 2020 Earthquake. Front Psychiatry 2021; 12:795661. [PMID: 35185639 PMCID: PMC8847377 DOI: 10.3389/fpsyt.2021.795661] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 12/22/2021] [Indexed: 12/19/2022] Open
Abstract
On the 29th of December 2020, amidst the COVID-19 pandemic, Petrinja in the Croatian Sisak-Moslavina County experienced a strong earthquake, resulting in a severe disruption in mental health service delivery. Specialized care community mental health teams were introduced days within the event with the aim to bridge the gap in psychiatric care that was severely disturbed in the region affected by the earthquake. Through a case series of patients with SMI, we describe how care was quickly deployed and delivered after a natural disaster and during a pandemic resulting in their functional recovery. Community mental health teams have the potential to provide feasible, comprehensive, and accessible mental health services, and their continued implementation in the post-disaster period in Croatia could be beneficial for care management of people with severe mental illness.
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Affiliation(s)
- Sara Medved
- Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Zagreb, Croatia
| | | | - Igor Salopek
- Department of Psychiatry, General Hospital Karlovac, Karlovac, Croatia
| | - Dragan Puljić
- Neuropsychiatric Hospital "Dr Ivan Barbot", Popovača, Croatia
| | - Hrvoje Handl
- University Psychiatric Clinic "Sveti Ivan", Zagreb, Croatia
| | - Marina Kovač
- Neuropsychiatric Hospital "Dr Ivan Barbot", Popovača, Croatia
| | - Alma Mihaljević Peleš
- Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Danijela Štimac Grbic
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Croatian Institute of Public Health, Zagreb, Croatia
| | - Luka Romančuk
- Department of Psychiatry, General Hospital Karlovac, Karlovac, Croatia
| | - Roberto MuŽić
- Croatian Institute of Public Health, Zagreb, Croatia
| | - Laura Shields Zeeman
- Department of Mental Health Prevention, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, Netherlands
| | - Martina Rojnić Kuzman
- Department of Psychiatry and Psychological Medicine, Zagreb University Hospital Centre, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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Omboni S, McManus RJ, Bosworth HB, Chappell LC, Green BB, Kario K, Logan AG, Magid DJ, Mckinstry B, Margolis KL, Parati G, Wakefield BJ. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension 2020; 76:1368-1383. [PMID: 32921195 DOI: 10.1161/hypertensionaha.120.15873] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Telemedicine allows the remote exchange of medical data between patients and healthcare professionals. It is used to increase patients' access to care and provide effective healthcare services at a distance. During the recent coronavirus disease 2019 (COVID-19) pandemic, telemedicine has thrived and emerged worldwide as an indispensable resource to improve the management of isolated patients due to lockdown or shielding, including those with hypertension. The best proposed healthcare model for telemedicine in hypertension management should include remote monitoring and transmission of vital signs (notably blood pressure) and medication adherence plus education on lifestyle and risk factors, with video consultation as an option. The use of mixed automated feedback services with supervision of a multidisciplinary clinical team (physician, nurse, or pharmacist) is the ideal approach. The indications include screening for suspected hypertension, management of older adults, medically underserved people, high-risk hypertensive patients, patients with multiple diseases, and those isolated due to pandemics or national emergencies.
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Affiliation(s)
- Stefano Omboni
- From the Clinical Research Unit, Italian Institute of Telemedicine, Varese (S.O.).,Scientific Research Department of Cardiology, Science and Technology Park for Biomedicine, Sechenov First Moscow State Medical University, Russian Federation (S.O.)
| | - Richard J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom (R.J.M.)
| | - Hayden B Bosworth
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Medical Center, NC (H.B.B.).,Department of Psychiatry and Behavioral Sciences (H.B.B.), Duke University, Durham, NC.,Division of General Internal Medicine (H.B.B.), Duke University, Durham, NC.,Department of Population Health Sciences (H.B.B.), Duke University, Durham, NC
| | - Lucy C Chappell
- Women's Health Academic Centre, King's College London, United Kingdom (L.C.C.)
| | - Beverly B Green
- Kaiser Permanente Washington Health Research Institute, Seattle (B.B.G.)
| | - Kazuomi Kario
- Department of Cardiology, Jichi Medical University School of Medicine, Tochigi, Japan (K.K.)
| | - Alexander G Logan
- Department of Medicine, Mount Sinai Hospital, University Health Network and University of Toronto, ON, Canada (A.G.L.)
| | - David J Magid
- Colorado Permanente Medical Group, Denver and School of Public Health, University of Colorado, Aurora (D.J.M.)
| | - Brian Mckinstry
- Emeritus Professor of Primary Care eHealth, Usher Institute, The University of Edinburgh, United Kingdom (B.M.)
| | | | - Gianfranco Parati
- Department of Medicine and Surgery, University of Milano-Bicocca, Italy (G.P.).,Istituto Auxologico Italiano, IRCCS San Luca, Milano, Italy (G.P.)
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Kloner RA. Lessons learned about stress and the heart after major earthquakes. Am Heart J 2019; 215:20-26. [PMID: 31260902 DOI: 10.1016/j.ahj.2019.05.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/26/2019] [Indexed: 01/27/2023]
Abstract
There is evidence that certain stressors can trigger cardiovascular events. Several studies have now demonstrated an increase in major adverse cardiac events associated with natural disasters such as an earthquake. The purpose of this paper is to review the literature on earthquakes and cardiovascular events. Reports from 13 major quakes were reported. Earthquakes have been associated with a number of cardiac events including sudden cardiac death, fatal myocardial infarction (MI), myocardial infarction, stress cardiomyopathy, heart failure, stroke, arrhythmias, hypertension and pulmonary embolism. Most reports were associated with earthquakes of magnitude 6.0 or greater. Cardiac events were reported within hours of the quakes. In some reports there was a sharp spike in cardiac events followed by a decrease; but in other quakes the increases in cardiac events lasted weeks, months and even years. There often was an association between the cardiac events and amount of personal property loss. The Great East Japan Earthquake was an unusual event in that it was associated with a major tsunami and cardiac events appeared worse in inundated areas due to flooding. Some but not all reports suggested more MIs associated with early morning earthquakes that woke up the population. Hospitals in earthquake-prone areas should consider developing plans for handling increases in myocardial infarctions and other cardiac events that are associated with earthquakes.
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Affiliation(s)
- Robert A Kloner
- Huntington Medical Research Institutes, Cardiovascular Research Institute, Pasadena, CA, and Keck School of Medicine of University of Southern California, Dept. of Medicine and Division of Cardiovascular Medicine, Los Angeles, CA..
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Howell AV, Vena JE, Cai B, Lackland DT, Ingram LA, Lawson AB, Svendsen ER. Temporal Trends in Cardiovascular Hospital Discharges Following a Mass Chlorine Exposure Event in Graniteville, South Carolina. Front Public Health 2019; 7:112. [PMID: 31134174 PMCID: PMC6517492 DOI: 10.3389/fpubh.2019.00112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/17/2019] [Indexed: 01/14/2023] Open
Abstract
Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds of hospitalizations and outpatient visits in the subsequent weeks. While chlorine gas primarily affects the respiratory tract, a growing body of evidence suggests that acute exposure may also cause vascular injury and cardiac toxicity. Here, we describe the incidence of cardiovascular hospitalizations among residents of the zip codes most affected by the chlorine gas plume, and compare the incidence of cardiovascular discharges in the years leading up to the event (2000-2004) to the incidence in the years following the event (2005-2014). Methods: De-identified hospital discharge information was collected from the South Carolina Revenue and Fiscal Affairs Office for individuals residing in the selected zip codes for the years 2000 to 2014. A quasi-experimental study design was utilized with a population-level interrupted time series model to examine hospital discharge rates for Graniteville-area residents for three cardiovascular diagnoses: hypertension (HTN), acute myocardial infarction (AMI), and coronary heart disease (CHD). We used linear regression with autoregressive error correction to compare slopes for pre- and post-spill time periods. Data from the 2000 and 2010 censuses were used to calculate rates and to provide information on potential demographic shifts over the course of the study. Results: A significant increase in hypertension-related hospital discharge rates was observed for the years following the Graniteville chlorine spill (slope 8.2, p < 0.001). Concurrent changes to CHD and AMI hospital discharge rates were in the opposite direction (slopes -3.2 and -0.3, p < 0.01 and 0.14, respectively). Importantly, the observed trend cannot be attributed to an aging population. Conclusions: An unusual increase in hypertension-related hospital discharge rates in the area affected by the Graniteville chlorine spill contrasts with national and state-level trends. A number of factors related to the spill may be contributing the observation: disaster-induced hypertension, healthcare services access issues, and, possibly, chlorine-induced susceptibility to vascular pathologies. Due to the limitations of our data, we cannot determine whether the individuals who visited the hospital were the ones exposed to chlorine gas, however, the finding warrants additional research. Future studies are needed to determine the etiology of the increase and whether individuals exposed to chlorine are at a heightened risk for hypertensive heart disease.
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Affiliation(s)
- Ashley V. Howell
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - John E. Vena
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Bo Cai
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Daniel T. Lackland
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Lucy A. Ingram
- Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
| | - Andrew B. Lawson
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Erik R. Svendsen
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, United States
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Tsuboya T, Inoue M, Satoh M, Asayama K. Perspectives acquired through long-term epidemiological studies on the Great East Japan Earthquake. Environ Health Prev Med 2017; 22:3. [PMID: 29165127 PMCID: PMC5661910 DOI: 10.1186/s12199-017-0615-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Accepted: 03/04/2017] [Indexed: 11/25/2022] Open
Abstract
The Great East Japan Earthquake (GEJE) and subsequent tsunamis that occurred in 2011 caused extensive and severe structural damage and interrupted numerous research activities; however, the majority of such activities have been revived, and further public health researches and activities have started to follow the population affected by the disaster. In this mini-review, we overview our recent activities regarding epidemiologic studies in Miyagi Prefecture, the region most affected by the GEJE. Through our study processes, we were able to identify the particular characteristics of vulnerable populations, and provide ideas that may help save lives and reduce the amount of damage caused by a future disaster. Long-term follow-up and care of survivors is essential in affected areas, and health professionals should pay particular attention to various diseases, e.g., cardiovascular complications and mental disorders. Furthermore, building up resilience and social relationships in the community is beneficial to survivors. Ongoing cohort studies conducted before disasters can help minimize biases regarding the survivors’ pre-disaster information, and emerging cohort studies after disasters can find potential helpful novel indices. To identify characteristics of vulnerable populations, save lives, and reduce the amount of damage caused by a future disaster, constant research that is consistently improved by new data needs to be performed.
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Affiliation(s)
- Toru Tsuboya
- Liaison Center for Innovative Dentistry / Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, 4-1, Seiryo-cho, Aoba-ku, Sendai, 980-0872, Japan
| | - Mariko Inoue
- Graduate School of Public Health, Teikyo University, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, 4-4-1 Komatsushima, Aobaku, Sendai, 981-8558, Japan
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan. .,Department of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, 2-1 Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan.
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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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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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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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Predictors of Hypertension in Survivors of the Great East Japan Earthquake, 2011: A Cross-sectional Study. Prehosp Disaster Med 2016; 31:17-26. [DOI: 10.1017/s1049023x15005440] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractIntroductionMany survivors of a major disaster die shortly after the event. Hypertension (HT) is one of the most important risk factors for these disaster-related diseases. An urgent need exists to establish methods to detect disaster survivors with HT and start medication immediately, as those with no injuries or symptoms may not be examined and medical teams cannot measure all survivors’ blood pressure (BP) because they often do not have sufficient time.ObjectiveThe goals of this report were: (1) to evaluate the importance of taking antihypertensive drugs continuously for patients with HT during the sub-acute phase after a major earthquake, when patients cannot attend a clinic because of destruction of the local infrastructure; and (2) to establish simple and reliable predictors to detect evacuees with HT, who require clinical examination and treatment at evacuation shelters or in their homes after a major earthquake.MethodsMedical rounds were performed at evacuation shelters in Iwate Prefecture after the Great East Japan Earthquake. Forty evacuees were enrolled in a cross-sectional study. The effect of taking antihypertensive drugs continuously was evaluated and predictors of HT in evacuees were identified using multiple logistic regression analysis.ResultsTwenty-eight evacuees were hypertensive (70%), nine of whom were asymptomatic (32%). Most evacuees who had discontinued antihypertensive medication (92%; 11/12) had very high BP, while those who had continued antihypertensive medication (80%; 8/10) were mildly hypertensive. The systolic BP of those who had discontinued antihypertensive drugs was significantly higher than that of those who had continued hypertensive drugs in the whole cohort (n=40), and also in evacuees diagnosed as having HT at evacuation shelters (n=28; P<.01 for both comparisons). A history of HT (adjusted odds ratio [aOR], 11.40; 95% confidence interval [CI], 1.03-126.08) or age >55 years (aOR, 1.10; 95% CI, 1.01-1.21) predicted HT with a sensitivity of 0.96 and specificity of 0.80.ConclusionsThe results of this study suggest that continuity of antihypertensive medication prevents serious HT at evacuation shelters in the first 10 days after a major earthquake. Onsite medical rounds focusing on simple predictors in an early stage after disasters may be an effective means of detecting and treating hypertensive disaster victims before they succumb to a fatal disease.TanakaR, OkawaM, UjikeY. Predictors of hypertension in survivors of the Great East Japan Earthquake, 2011: a cross-sectional study. Prehosp Disaster Med. 2016;31(1):17–26.
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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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Nishizawa M, Hoshide S, Okawara Y, Shimpo M, Matsuo T, Kario K. Aftershock Triggers Augmented Pressor Effects in Survivors: Follow-Up of the Great East Japan Earthquake. Am J Hypertens 2015; 28:1405-8. [PMID: 25890830 DOI: 10.1093/ajh/hpv044] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 01/15/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Previous reports focused on the significant acute effects immediately after an earthquake on an increase in blood pressure (BP) assessed by ambulatory BP monitoring. However, there have been no data on the impact of environmental triggers on the long-term response to earthquake. METHODS We analyzed the ambulatory BP monitoring data of 8 patients who lived in the disaster area of the 11 March 2011 Great East Japan Earthquake on the day of the largest aftershock with a first tsunami warming (sirens) on 7 December 2012. RESULTS There was no significant difference in the BP in either the period 1 hour before (median (range): 126.5 (121.5-138.0) vs. 137.8 (129.5-177.0) mm Hg, P = 0.07) or that 1 hour after (139.3 (113.0-143.5) vs. 137.5 (125.0-192.0) mm Hg, P = 0.27) the aftershock between those living at home and those who had been living in temporary housing. After the time of aftershock, the systolic BP levels at that night (124.9 (113.2-137.9) vs. 107.0 (101.9-110.1) mm Hg, P = 0.021) and systolic BP levels at the following morning (149.3 (131.0-196.2) vs. 129.5 (128.8-131.0) mm Hg, P = 0.029) were also significantly higher in those living in temporary housing at the time compared to those living in their own homes. CONCLUSION Our data suggest that the stress of a change in living conditions following the disaster might have contributed an increased risk of cardiovascular events.
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Affiliation(s)
- Masafumi Nishizawa
- Department of Medicine, Minamisanriku Public Medical Clinic, Minamisanriku, Motoyoshi-gun, Miyagi, Japan; Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, 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
| | - Masahisa Shimpo
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan
| | - Takefumi Matsuo
- 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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Burden of cardiovascular morbidity and mortality following humanitarian emergencies: a systematic literature review. Prehosp Disaster Med 2014; 30:80-8. [PMID: 25499440 DOI: 10.1017/s1049023x14001356] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The global burden of cardiovascular mortality is increasing, as is the number of large-scale humanitarian emergencies. The interaction between these phenomena is not well understood. This review aims to clarify the relationship between humanitarian emergencies and cardiovascular morbidity and mortality. METHODS With assistance from a research librarian, electronic databases (PubMed, Scopus, CINAHL, and Global Health) were searched in January 2014. Findings were supplemented by reviewing citations of included trials. Observational studies reporting the effect of natural disasters and conflict events on cardiovascular morbidity and mortality in adults since 1997 were included. Studies without a comparison group were not included. Double-data extraction was utilized to abstract information on acute coronary syndrome (ACS), acute decompensated heart failure (ADHF), and sudden cardiac death (SCD). Review Manager 5.0 (Version 5.2, The Nordic Cochrane Centre; Copenhagen Denmark,) was used to create figures for qualitative synthesis. RESULTS The search retrieved 1,697 unique records; 24 studies were included (17 studies of natural disasters and seven studies of conflict). These studies involved 14,583 cardiac events. All studies utilized retrospective designs: four were population-based, 15 were single-center, and five were multicenter studies. Twenty-three studies utilized historical controls in the primary analysis, and one utilized primarily geographical controls. DISCUSSION Conflicts are associated with an increase in long-term morbidity from ACS; the short-term effects of conflict vary by study. Natural disasters exhibit heterogeneous effects, including increased occurrence of ACS, ADHF, and SCD. CONCLUSIONS In certain settings, humanitarian emergencies are associated with increased cardiac morbidity and mortality that may persist for years following the event. Humanitarian aid organizations should consider morbidity from noncommunicable disease when planning relief and recuperation projects.
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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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Yokoyama Y, Hirano K, Sato M, Abe A, Uebayashi M, Kishi E, Sato M, Kuroda Y, Nakaita I, Fukushima F. Activities and health status of dispatched public health nurses after the great East Japan earthquake. Public Health Nurs 2014; 31:537-44. [PMID: 25080024 PMCID: PMC4282791 DOI: 10.1111/phn.12141] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to elucidate the actual activities conducted by public health nurses during their dispatch and their health status during and after dispatch to the three prefectures most severely affected by the Great East Japan Earthquake. SAMPLE A survey request was sent to a total of 2,237 facilities. Of these, 778 facilities returned questionnaires from dispatched public health nurses. RESULTS The participants of this study were 1,570 dispatched health nurses who participated in activities mostly at evacuation centers, followed by evacuees' homes. After dispatch, an earlier postdisaster phase at the start of dispatch was independently associated with poor subjective well-being, low mood, worsened sleep state, and intense fatigue. Work hours per day were associated with poor subjective well-being and intense fatigue after dispatch. CONCLUSION Results suggest that the factor that most strongly affected the postdispatch health of the nurses was the phase that they began their dispatch.
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Affiliation(s)
- Yoshie Yokoyama
- Department of Public Health Nursing, Osaka City University, Osaka, Japan
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Disaster relief activities of the Japan self-defense force following the Great East Japan Earthquake. Disaster Med Public Health Prep 2014; 8:194-198. [PMID: 24901381 DOI: 10.1017/dmp.2014.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Cooperation between civilian and military forces, including the Japan Self-Defense Force (JSDF), enabled wide-ranging disaster relief after the Great East Japan Earthquake. Nevertheless, many preventable fatalities occurred, particularly related to an inability to treat chronic disease, indicating the need to plan for the provision of long-term medical aid after natural disasters in stricken areas and evacuation shelters. To assist in this effort, this report (1) provides an overview of the consequences of the medical response to the Great East Japan Earthquake, the largest natural disaster ever to hit Japan, focusing on the role and actions of the JSDF; (2) discusses the lessons learned regarding the provision of medical aid and management by the JSDF after this disaster, looking at the special challenges of meeting the needs of a rapidly aging population in a disaster situation; and (3) provides recommendations for the development of strategies for the long-term medical aid and support after natural disasters, especially with regard to the demographics of the Japanese population.
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Nishizawa M. [Series: Physicians and disaster medical care; Third stage. Management and education for disaster medicine: disaster medical cordination system. (2). The Great East Japan earthquake]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:1002-1007. [PMID: 24909001 DOI: 10.2169/naika.103.1002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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