Hypertension 10.5%, stroke 6.6%, asthma 5%, COPD 4%, diabetes mellitus 1.3%, cancer 1%, coronary heart disease 0.5%. In Cipunagara Health Center at 2016, the number of NCD (non-communicable disease) was 1,098 cases an...Hypertension 10.5%, stroke 6.6%, asthma 5%, COPD 4%, diabetes mellitus 1.3%, cancer 1%, coronary heart disease 0.5%. In Cipunagara Health Center at 2016, the number of NCD (non-communicable disease) was 1,098 cases and 53.6% cases were hypertension. Research purpose was to prove risk factor of hypertension in Cipunagara Health Center, Subang district at year 2017. Materials and methode: Research applied, crossectional, sample 61 respondents, incidental sampling, one day in Cipunagara and analyzed descriptive and analytic correlation. Results: 85.2% hypertension and complication, 14.8% diabetes mellitus, age ≥ 60 year 52.5%, women 73.8%, elementary level education 93.4%, housewife 54.1%, farmer 39.3%, genetic 75.4 %, smoking 23.0%, alcohol 24.6%, less activity 82%, less fruit and vegetables 80.3%, high salt consumption more than 1 tablespoon 68.9%, high caloric consumption 52.5%, good manage stress 73.8%, obesity 59%, abdominal sircumference normal 70.5%. Correlation results showed only salt consumption was significant and other variables included in model regression smoking, alcohol, stress, calory, activity. Final model of regression salt consumption p 0.019, OR 6.693, 95% CI.1.374-32.612, R216%;caloric consumption p 0.099, OR 0.229, 95% CI 0.040-1.322, R28%. Conclusions: non-communicable diseases risk factor was highest consumption salt and calory has contributed 24 %. Suggestions: reduced salt and calory consumption, salt engineering for reduce hypertension.展开更多
Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review ...Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review on the extent to which research in this field has developed over the years,and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens,guidelines and into gender-oriented preventive strategies and health policies.Subsequently,through the lens of gender,we describe these domains in detail for four selected medical conditions:Asthma,obesity and overweight,chronic kidney disease and coronavirus disease 2019.As some of the key gender differences become more apparent during adolescence,we focus on this developmental stage.Finally,we propose a model which is based on three influential issues:(1)Investigating gender-specific medical profiles of related health conditions,rather than a single disease;(2)The dynamics of gender disparities across developmental stages;and(3)An integrative approach which takes into account additional risk factors(ethnicity,socio-demographic variables,minorities,lifestyle habits etc.).Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines,already among adolescents,may reduce inequities,facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.展开更多
Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of...Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). Methods: From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretroviral (ARV) prophylaxis and ART, were recruited from 22 purposefully selected health facilities in the Northwest and Southwest regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Results: Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85 - 92.61) and 79% (95% CI, 75.20 - 81.88), and loss to follow up (LTFU) was 7% (95% CI: 4.95 - 8.90) and 15% (95% CI: 12.06 - 17.56) at 6 and 12 months respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum nevirapine prophylaxis within 72 hours of birth and 84% (454) were on cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 498 (93%) infants had HIV DNA PCR test with 486 (97.6%) negative and 12 (2.4%) positive. Conclusion: In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.展开更多
Presence of higher breast density(BD)and persistence over time are risk factors for breast cancer.A quantitatively accurate and highly reproducible BD measure that relies on precise and reproducible whole-breast segme...Presence of higher breast density(BD)and persistence over time are risk factors for breast cancer.A quantitatively accurate and highly reproducible BD measure that relies on precise and reproducible whole-breast segmentation is desirable.In this study,we aimed to develop a highly reproducible and accurate whole-breast segmentation algorithm for the generation of reproducible BD measures.Three datasets of volunteers from two clinical trials were included.Breast MR images were acquired on 3T Siemens Biograph mMR,Prisma,and Skyra using 3D Cartesian six-echo GRE sequences with a fat-water separation technique.Two whole-breast segmentation strategies,utiliz-ing image registration and 3D U-Net,were developed.Manual segmentation was performed.A task-based analysis was performed:a previously developed MR-based BD measure,MagDensity,was calculated and assessed using automated and manual segmentation.The mean squared error(MSE)and intraclass correlation coefficient(ICC)between MagDensity were evaluated using the manual segmentation as a reference.The test-retest reproducibility of MagDensity derived from different breast segmentation methods was assessed using the difference between the test and retest measures(Δ_(2-1)),MSE,and ICC.The results showed that MagDensity derived by the registration and deep learning segmentation methods exhibited high concordance with manual segmentation,with ICCs of 0.986(95%CI:0.974-0.993)and 0.983(95%CI:0.961-0.992),respectively.For test-retest analysis,MagDensity derived using the regis-tration algorithm achieved the smallest MSE of 0.370 and highest ICC of 0.993(95%CI:0.982-0.997)when compared to other segmentation methods.In conclusion,the proposed registration and deep learning whole-breast segmentation methods are accurate and reliable for estimating BD.Both methods outperformed a previously developed algorithm and manual segmentation in the test-retest assessment,with the registration exhibiting superior performance for highly reproducible BD measurements.展开更多
文摘Hypertension 10.5%, stroke 6.6%, asthma 5%, COPD 4%, diabetes mellitus 1.3%, cancer 1%, coronary heart disease 0.5%. In Cipunagara Health Center at 2016, the number of NCD (non-communicable disease) was 1,098 cases and 53.6% cases were hypertension. Research purpose was to prove risk factor of hypertension in Cipunagara Health Center, Subang district at year 2017. Materials and methode: Research applied, crossectional, sample 61 respondents, incidental sampling, one day in Cipunagara and analyzed descriptive and analytic correlation. Results: 85.2% hypertension and complication, 14.8% diabetes mellitus, age ≥ 60 year 52.5%, women 73.8%, elementary level education 93.4%, housewife 54.1%, farmer 39.3%, genetic 75.4 %, smoking 23.0%, alcohol 24.6%, less activity 82%, less fruit and vegetables 80.3%, high salt consumption more than 1 tablespoon 68.9%, high caloric consumption 52.5%, good manage stress 73.8%, obesity 59%, abdominal sircumference normal 70.5%. Correlation results showed only salt consumption was significant and other variables included in model regression smoking, alcohol, stress, calory, activity. Final model of regression salt consumption p 0.019, OR 6.693, 95% CI.1.374-32.612, R216%;caloric consumption p 0.099, OR 0.229, 95% CI 0.040-1.322, R28%. Conclusions: non-communicable diseases risk factor was highest consumption salt and calory has contributed 24 %. Suggestions: reduced salt and calory consumption, salt engineering for reduce hypertension.
文摘Gender-specific differences in the prevalence,incidence,comorbidities,prognosis,severity,risk factors,drug-related aspects and outcomes of various medical conditions are well documented.We present a literature review on the extent to which research in this field has developed over the years,and reveal gaps in gender-sensitive awareness between the clinical portrayal and the translation into gender-specific treatment regimens,guidelines and into gender-oriented preventive strategies and health policies.Subsequently,through the lens of gender,we describe these domains in detail for four selected medical conditions:Asthma,obesity and overweight,chronic kidney disease and coronavirus disease 2019.As some of the key gender differences become more apparent during adolescence,we focus on this developmental stage.Finally,we propose a model which is based on three influential issues:(1)Investigating gender-specific medical profiles of related health conditions,rather than a single disease;(2)The dynamics of gender disparities across developmental stages;and(3)An integrative approach which takes into account additional risk factors(ethnicity,socio-demographic variables,minorities,lifestyle habits etc.).Increasing the awareness of gender-specific medicine in daily practice and in tailored guidelines,already among adolescents,may reduce inequities,facilitate the prediction of future trends and properly address the characteristics and needs of certain subpopulations within each gender.
文摘Background: Mother to child transmission (MTCT) of HIV constitutes a major source of new pediatric infections in Cameroon. Objective: The aim of this implementation research was to assess outcomes and effectiveness of providing life-long antiretroviral therapy (ART) for HIV-positive pregnant and breastfeeding women (Option B+). Methods: From October 2013 to July 2014, HIV-positive pregnant and breastfeeding women, not on antiretroviral (ARV) prophylaxis and ART, were recruited from 22 purposefully selected health facilities in the Northwest and Southwest regions for a prospective, observational cohort evaluation. Option B+ was offered to participants and outcome indicators were measured. Results: Out of 680 women eligible for this assessment, 669 (98%) were initiated on Option B+. Retention-in-care was 90% (95% CI, 87.85 - 92.61) and 79% (95% CI, 75.20 - 81.88), and loss to follow up (LTFU) was 7% (95% CI: 4.95 - 8.90) and 15% (95% CI: 12.06 - 17.56) at 6 and 12 months respectively. Maternal mortality at 12 months after ART initiation was 2% (13). As of March 2015, 538 HIV exposed infants (HEIs) were enrolled and received postpartum nevirapine prophylaxis within 72 hours of birth and 84% (454) were on cotrimoxazole at 6 to 8 weeks. By 8 weeks of age, 498 (93%) infants had HIV DNA PCR test with 486 (97.6%) negative and 12 (2.4%) positive. Conclusion: In Cameroon, successful implementation of Option B+ increased retention-in-care to 79% at one year for pregnant and breastfeeding women and reduced MTCT rate below 5% for HEIs at 8 weeks of age. Long term retention, maternal and infant mortality and final MTCT rate after cessation of breastfeeding require further evaluation.
基金This work is partially supported by the National Institute of Health R03CA223052The sulindac trial was supported by R01CA161534The metformin trial was supported by R01CA172444 and P30CA023074。
文摘Presence of higher breast density(BD)and persistence over time are risk factors for breast cancer.A quantitatively accurate and highly reproducible BD measure that relies on precise and reproducible whole-breast segmentation is desirable.In this study,we aimed to develop a highly reproducible and accurate whole-breast segmentation algorithm for the generation of reproducible BD measures.Three datasets of volunteers from two clinical trials were included.Breast MR images were acquired on 3T Siemens Biograph mMR,Prisma,and Skyra using 3D Cartesian six-echo GRE sequences with a fat-water separation technique.Two whole-breast segmentation strategies,utiliz-ing image registration and 3D U-Net,were developed.Manual segmentation was performed.A task-based analysis was performed:a previously developed MR-based BD measure,MagDensity,was calculated and assessed using automated and manual segmentation.The mean squared error(MSE)and intraclass correlation coefficient(ICC)between MagDensity were evaluated using the manual segmentation as a reference.The test-retest reproducibility of MagDensity derived from different breast segmentation methods was assessed using the difference between the test and retest measures(Δ_(2-1)),MSE,and ICC.The results showed that MagDensity derived by the registration and deep learning segmentation methods exhibited high concordance with manual segmentation,with ICCs of 0.986(95%CI:0.974-0.993)and 0.983(95%CI:0.961-0.992),respectively.For test-retest analysis,MagDensity derived using the regis-tration algorithm achieved the smallest MSE of 0.370 and highest ICC of 0.993(95%CI:0.982-0.997)when compared to other segmentation methods.In conclusion,the proposed registration and deep learning whole-breast segmentation methods are accurate and reliable for estimating BD.Both methods outperformed a previously developed algorithm and manual segmentation in the test-retest assessment,with the registration exhibiting superior performance for highly reproducible BD measurements.
