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Cénat JM, Dromer E, Farahi SMMM, Ndamage CM, Yun A, Zuta H, Mkhatri J, Samson E, Barara R, Labelle PR, Xu Y. Venous thromboembolism in Black COVID-19 patients in a minority context compared to White, Asian and other racialized patients: A systematic review and meta-analysis. Thromb Res 2024; 238:197-205. [PMID: 38733691 DOI: 10.1016/j.thromres.2024.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 04/26/2024] [Accepted: 05/06/2024] [Indexed: 05/13/2024]
Abstract
IMPORTANCE COVID-19 has disproportionately affected racialized populations, with particular impact among individuals of Black individuals. However, it is unclear whether disparities in venous thromboembolic (VTE) complications exist between Black individuals and those belonging to other racial groups with confirmed SARS-CoV2 infections. OBJECTIVE To summarize the prevalence and moderators associated with VTE among Black COVID-19 patients in minoritized settings, and to compare this to White and Asian COVID-19 patients according to sex, age, and comorbid health conditions (heart failure, cancer, obesity, hypertension). DESIGN SETTING, AND PARTICIPANTS A systematic search of MEDLINE, Embase, CINAHL and CENTRAL for articles or reports published from inception to February 15, 2023. STUDY SELECTION Reports on VTE among Black individuals infected with SARS-CoV2, in countries where Black people are considered a minority population group. DATA EXTRACTION AND SYNTHESIS Study characteristics and results of eligible studies were independently extracted by 2 pairs of reviewers. VTE prevalence was extracted, and risk of bias was assessed. Prevalence estimates of VTE prevalence among Black individuals with COVID19 in each study were pooled. Where studies provided race-stratified VTE prevalence among COVID19 patients, odds ratios were generated using a random-effects model. MAIN OUTCOMES AND MEASURES Prevalence of VTE, comprising of deep vein thrombosis and pulmonary embolism. RESULTS Ten studies with 66,185 Black individuals reporting the prevalence of COVID-19 associated VTE were included. Weighted median age of included studies was 47.60. Pooled prevalence of COVID-19 associated VTE was 7.2 % (95 % CI, 3.8 % - 11.5 %) among Black individuals. Among individuals with SARS-CoV2 infections, Black population had higher risks of VTE compared to their White (OR = 1.79, [95 % CI 1.28-2.53], p < .001) or Asian (OR = 2.01, [95 % CI, 1.14-3.60], p = .017) counterparts, or patients with other racial identities (OR = 2.01, [95 % CI, 1.39, 2.92]; p < .001). CONCLUSIONS AND RELEVANCE Black individuals with COVID-19 had substantially higher risk of VTE compared to White or Asian individuals. Given racial disparities in thrombotic disease burden related to COVID-19, medical education, research, and health policy interventions are direly needed to ensure adequate disease awareness among Black individuals, to facilitate appropriate diagnosis and treatment among Black patients with suspected and confirmed VTE, and to advocate for culturally safe VTE prevention strategies, including pre-existing inequalities to the COVID-19 pandemic that persist after the crisis.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, Ottawa, Ontario, Canada.
| | - Elisabeth Dromer
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | - Aiden Yun
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Hannah Zuta
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Jihane Mkhatri
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Eden Samson
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Raina Barara
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Yan Xu
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; The Ottawa Hospital, Ottawa, Ontario, Canada
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Lim A, Elias S, Benjasirisan C, Byiringiro S, Chen Y, Turkson‐Ocran R, Dennison Himmelfarb CR, Commodore‐Mensah Y, Koirala B. Heterogeneity in the Prevalence of Cardiovascular Risk Factors by Ethnicity and Birthplace Among Asian Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey. J Am Heart Assoc 2024; 13:e031886. [PMID: 38420759 PMCID: PMC10944060 DOI: 10.1161/jaha.123.031886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Asian people in the United States have different sociodemographic and health-related characteristics that might affect cardiovascular disease (CVD) risk by ethnicity and birthplace. However, they are often studied as a monolithic group in health care research. This study aimed to examine heterogeneity in CVD risk factors on the basis of birthplace among the 3 largest Asian subgroups (Chinese, Asian Indian, and Filipino) compared with US-born non-Hispanic White (NHW) adults. METHODS AND RESULTS A cross-sectional analysis was conducted using the 2010 to 2018 National Health Interview Survey data from 125 008 US-born and foreign-born Chinese, Asian Indian, Filipino, and US-born NHW adults. Generalized linear models with Poisson distribution were used to examine the prevalence and prevalence ratios of self-reported hypertension, diabetes, high cholesterol, physical inactivity, smoking, and overweight/obesity among Asian subgroups compared with US-born NHW adults. The study included 118 979 US-born NHW and 6029 Asian adults who self-identified as Chinese (29%), Asian Indian (33%), and Filipino (38%). Participants' mean (±SD) age was 49±0.1 years, and 53% were females. In an adjusted analysis, foreign-born Asian Indians had significantly higher prevalence of diabetes, physical inactivity, and overweight/obesity; foreign-born Chinese had higher prevalence of physical inactivity, and foreign-born Filipinos had higher prevalence of all 5 CVD risk factors except smoking compared with NHW adults. CONCLUSIONS This study revealed significant heterogeneity in the prevalence of CVD risk factors among Asian subgroups by ethnicity and birthplace, stressing the necessity of disaggregating Asian subgroup data. Providers should consider this heterogeneity in CVD risk factors and establish tailored CVD prevention plans for Asian subgroups.
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Affiliation(s)
- Arum Lim
- Johns Hopkins School of NursingBaltimoreMDUSA
| | | | | | | | - Yuling Chen
- Johns Hopkins School of NursingBaltimoreMDUSA
| | - Ruth‐Alma Turkson‐Ocran
- Beth Israel Deaconess Medical Center, Division of General MedicineHarvard Medical SchoolBostonMAUSA
| | - Cheryl R. Dennison Himmelfarb
- Johns Hopkins School of NursingBaltimoreMDUSA
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
- Johns Hopkins School of MedicineBaltimoreMDUSA
| | - Yvonne Commodore‐Mensah
- Johns Hopkins School of NursingBaltimoreMDUSA
- Johns Hopkins Bloomberg School of Public HealthBaltimoreMDUSA
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Deerochanawong C, Kim SG, Chang YC. Role of Fenofibrate Use in Dyslipidemia and Related Comorbidities in the Asian Population: A Narrative Review. Diabetes Metab J 2024; 48:184-195. [PMID: 38273789 PMCID: PMC10995494 DOI: 10.4093/dmj.2023.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 07/31/2023] [Indexed: 01/27/2024] Open
Abstract
Hypertriglyceridemia and decreased high-density lipoprotein cholesterol (HDL-C) persist despite statin therapy, contributing to residual atherosclerotic cardiovascular disease (ASCVD) risk. Asian subjects are metabolically more susceptible to hypertriglyceridemia than other ethnicities. Fenofibrate regulates hypertriglyceridemia, raises HDL-C levels, and is a recommended treatment for dyslipidemia. However, data on fenofibrate use across different Asian regions are limited. This narrative review summarizes the efficacy and safety data of fenofibrate in Asian subjects with dyslipidemia and related comorbidities (diabetes, metabolic syndrome, diabetic retinopathy, and diabetic nephropathy). Long-term fenofibrate use resulted in fewer cardiovascular (CV) events and reduced the composite of heart failure hospitalizations or CV mortality in type 2 diabetes mellitus. Fenofibrate plays a significant role in improving irisin resistance and microalbuminuria, inhibiting inflammatory responses, and reducing retinopathy incidence. Fenofibrate plus statin combination significantly reduced composite CV events risk in patients with metabolic syndrome and demonstrated decreased triglyceride and increased HDL-C levels with an acceptable safety profile in those with high CV or ASCVD risk. Nevertheless, care is necessary with fenofibrate use due to possible hepatic and renal toxicities in vulnerable individuals. Long-term trials and real-world studies are needed to confirm the clinical benefits of fenofibrate in the heterogeneous Asian population with dyslipidemia.
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Affiliation(s)
- Chaicharn Deerochanawong
- Diabetes and Endocrinology Unit, Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Yu-Cheng Chang
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Meeker TJ, Kim HJ, Tulloch IK, Keaser ML, Seminowicz DA, Dorsey SG. Secondary analysis: heat and self-report pain sensitivity associate with biological sex and racialized sociocultural group but may not be mediated by anxiety or pain catastrophizing. Pain Rep 2024; 9:e1133. [PMID: 38283650 PMCID: PMC10811695 DOI: 10.1097/pr9.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 10/10/2023] [Accepted: 10/24/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Previous studies have demonstrated associations between sex and racialized group on pain sensitivity and tolerance. We analyzed the association of sex and racialized group on heat pain sensitivity, sensibility to painful suprathreshold mechanical pain (STMP), and pain sensitivity questionnaire (PSQ). We hypothesized that anxiety and pain catastrophizing reported by racialized minority groups and women would mediate enhanced pain sensitivity. Our secondary aim was to evaluate validity of the PSQ in a diverse population. Methods Using quantitative sensory testing for painful heat, STMP (forces: 64, 128, 256, and 512 mN), and PSQ, we evaluated pain sensitivity in 134 healthy participants [34 (18 women) Asian, 25 (13 women) Black, and 75 (41 women) White]. We used general linear and linear mixed models to analyze outcomes. We assessed mediation of state and trait anxiety and pain catastrophizing on pain sensitivity. Results Racialized minority status was associated with greater heat pain sensitivity (F = 7.63; P = 0.00074) and PSQ scores (F = 15.45; P = 9.84 × 10-7) but not associated with STMP (F = 1.50; P = 0.23). Female sex was associated with greater heat pain sensitivity (F = 4.9; P = 0.029) and lower PSQ (F = 9.50; P = 0.0025) but not associated with STMP (F = 0.0018; P = 0.97). Neither anxiety nor pain catastrophizing mediated associations between sex or racialized group with heat pain threshold or PSQ. Differential experience of individual items (F = 19.87; P = 3.28 × 10-8) limited PSQ face validity in racialized minorities. Conclusion Consistent with previous research, sensitivity to painful heat was associated with racialized minority status and female sex. By contrast, there was no significant effect of racialized minority status or female sex on STMP. Some PSQ items are inapplicable to participants from racialized minority groups.
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Affiliation(s)
- Timothy J. Meeker
- Department of Biology, Morgan State University, Baltimore, MD, USA
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - Hee Jun Kim
- Community of Acute and Chronic Care, The George Washington University, Washington, DC, USA
| | - Ingrid K. Tulloch
- Department of Psychology, Morgan State University, Baltimore, MD, USA
| | - Michael L. Keaser
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
| | - David A. Seminowicz
- Department of Medical Biophysics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada
| | - Susan G. Dorsey
- Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, USA
- Department of Pain and Translational Symptom Sciences, University of Maryland School of Nursing, Baltimore, MD, USA
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Liu LS, Jia X, Zhu A, Ran GJ, Siegert R, French N, Johnston D. Stigmatising and Racialising COVID-19: Asian People's Experience in New Zealand. J Racial Ethn Health Disparities 2023; 10:2704-2717. [PMID: 36369460 PMCID: PMC9651882 DOI: 10.1007/s40615-022-01448-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/13/2022]
Abstract
The Asian community - the second largest non-European ethnic community in New Zealand - plays an important role in combatting the COVID-19 pandemic, evidenced by their active advocation for border control and mass masking. Despite the long history of racial discrimination against the Asian population, the Asian community has experienced certain degrees of racial discrimination associated with the stigmatisation as the cause of the COVID-19 outbreak in New Zealand. Based on data from a quantitative online survey with 402 valid responses within the Asian communities across New Zealand and the in-depth interviews with 19 Asian people in Auckland, New Zealand, this paper will illustrate Asian people's experience of racial discrimination and stigmatisation during the pandemic in the country. The survey shows that since the outbreak of COVID-19, under a quarter of the participants reported experiencing discrimination, and a third reported knowing an immediate contact who had experienced discrimination. However, when looking beyond their immediate social circle, an even higher proportion reported noticing racism and stigmatisation through the traditional or social media due to COVID-19. Major variations of the degree of racial discrimination experienced are determined by three demographic variables: ethnicity, age, and region. The in-depth interviews largely echoed the survey findings and highlighted a strong correlation between the perceived racial discrimination among the local Asian community and the stigmatisation associated with COVID-19. These findings are important for improving the way we manage future pandemics and other disasters within the context of the UN Sendai Framework for Disaster Risk Reduction.
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Affiliation(s)
- Liangni Sally Liu
- School of Humanities, Media and Creative Communication, Massey University, Auckland, New Zealand.
| | - Xiaoyun Jia
- Institute of Governance & School of Politics and Public Administration, Shangdong University, Qingdao, China
- School of Mathematical and Computational Sciences, Massey University, Auckland, New Zealand
| | - Andrew Zhu
- Trace Research Ltd, Auckland, New Zealand
| | - Guanyu Jason Ran
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Richard Siegert
- Department of Psychology & Neuroscience, School of Clinical Sciences, University of Technology, Auckland, New Zealand
| | - Nigel French
- Infectious Diseases Research Centre, Hopkirk Research Institute, Massey University, Palmerston North, New Zealand
| | - David Johnston
- Joint Centre for Disaster Research, Massey University, Wellington, New Zealand.
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Lim MK, Wong PS, Othman S, Mohd Mydin FH, Lim PS, Lai PSM. A Systematic Review of Non-Seriously Ill Community-Dwelling Asians' Views on Advance Care Planning. J Am Med Dir Assoc 2023; 24:1831-1842. [PMID: 37844872 DOI: 10.1016/j.jamda.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/05/2023] [Accepted: 09/08/2023] [Indexed: 10/18/2023]
Abstract
OBJECTIVES To systematically synthesize the views of community-dwelling Asians on Advance care planning and to summarize the factors and reasons affecting their uptake of ACP. DESIGN Mixed-methods systematic review (PROSPERO: CRD42018091033). SETTING AND PARTICIPANTS Asian adults (≥18 years old) living in the community globally. METHODS Medline (Ovid), Web of Science, CINAHL (EBSCO), Open Grey, and Google Scholar were searched from inception to June 30, 2022. Qualitative, quantitative, or mixed-methods studies reporting on the views of non-seriously ill community-dwelling Asian adults on ACP or the factors influencing their ACP uptake were included. Secondary research, studies not published in English, or studies not available as full text were excluded. Two independent teams of researchers extracted data, assessed methodologic quality, and performed the data analysis. Data analysis was conducted using the multistep convergent integrated approach based on Joanna Briggs Institute methodology for mixed-methods systematic review. RESULTS Fifty-eight studies were included. Non-seriously ill community-dwelling Asians were willing to engage in ACP (46.5%-84.4%) although their awareness (3.1%-42.9%) and uptake of ACP remained low (14.0%-53.4%). Background factors (sociodemographic factors, and health status, as well as experience and exposure to information) and underlying beliefs (attitude toward ACP, subjective norm, and perceived behavioral control) were found to affect their uptake of ACP. A conceptual framework was developed to facilitate a proper approach to ACP for this population. CONCLUSIONS AND IMPLICATIONS A flexible approach toward ACP is needed for non-seriously ill community-dwelling Asians. There is also a need to raise end-of-life and ACP literacy, and to explore ways to narrow the gap in the expectations and implementation of ACP so that trust in its effective execution can be built.
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Affiliation(s)
- Mun Kit Lim
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia; School of Pharmacy, Monash University, Selangor, Malaysia
| | - Pei Se Wong
- International Medical University, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia
| | - Pei Shan Lim
- Anaesthetic Department, Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Wilayah Persekutuan, Malaysia.
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Lavie CJ, daSilva-deAbreu A, Ventura HO, Mehra MR. Is There an Obesity Paradox in Cardiogenic Shock? J Am Heart Assoc 2022; 11:e026088. [PMID: 35658482 PMCID: PMC9238744 DOI: 10.1161/jaha.122.026088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Carl J Lavie
- John Ochsner Heart and Vascular InstituteOchsner Clinical School - The University of Queensland School of Medicine New Orleans LA
| | - Adrian daSilva-deAbreu
- Section of Cardiovascular Medicine Yale School of MedicineHeart and Vascular CenterYale-New Haven Hospital New Haven CT
| | - Hector O Ventura
- John Ochsner Heart and Vascular InstituteOchsner Clinical School - The University of Queensland School of Medicine New Orleans LA
| | - Mandeep R Mehra
- Brigham and Women's Hospital and Harvard Medical School Boston MA
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Rai SS, Syurina EV, Peters RMH, Putri AI, Irwanto I, Zweekhorst MBM. How do Positive Deviants Overcome Health-Related Stigma? An Exploration of Development of Positive Deviance Among People With Stigmatized Health Conditions in Indonesia. Qual Health Res 2022; 32:622-634. [PMID: 34904455 PMCID: PMC8853968 DOI: 10.1177/10497323211058164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A constructivist grounded theory approach was used to understand how some people living with stigmatized health conditions develop positive deviance to overcome stigma. We examined interviews from 13 identified positive deviants living with four different stigmatized health conditions (HIV, leprosy, schizophrenia, and diabetes) in Indonesia. Positive deviance develops in the form of psychological empowerment through improvement of self-belief and perception (intrapersonal component), development of understanding and skill to exert control in life (interactional component), and self-discovery of successful behaviors and strategies to avert stigma (behavioral component). Positive deviants, after being empowered, start empowering others affected by sharing their knowledge and fostering social awareness and acceptance. The findings revealed the presence of problem-solving ability and agency within the community of stigmatized individuals in Indonesia and warrant researchers to partner with the community to expedite the diffusion of transferable positive deviant strategies within and outside the communities.
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Affiliation(s)
- Sarju Sing Rai
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Barcelona Institute for Global Health (ISGlobal), University of Barcelona, Barcelona, Spain
| | - Elena V. Syurina
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ruth M. H. Peters
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annisa Ika Putri
- Athena Institute, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irwanto Irwanto
- Faculty of Psychology, Atma Jaya Catholic University, Jakarta, Indonesia
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Kaneko M, Fujihara K, Harada MY, Osawa T, Yamamoto M, Kitazawa M, Matsubayashi Y, Yamada T, Seida H, Kodama S, Sone H. Rates and risk factors for amputation in people with diabetes in Japan: a historical cohort study using a nationwide claims database. J Foot Ankle Res 2021; 14:29. [PMID: 33836779 PMCID: PMC8034178 DOI: 10.1186/s13047-021-00474-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/03/2021] [Indexed: 01/30/2023] Open
Abstract
Background The prevalence of diabetes is rising, and diabetes develops at a younger age in East Asia. Although lower limb amputation negatively affects quality of life and increases the risk of cardiovascular events, little is known about the rates and predictors of amputation among persons with diabetes from young adults to those in the “young-old” category (50–72 y). Methods We analyzed data from a nationwide claims database in Japan accumulated from 2008 to 2016 involving 17,288 people with diabetes aged 18–72 y (mean age 50.2 y, HbA1c 7.2%). Amputation occurrence was determined according to information from the claims database. Cox regression model identified variables related to lower limb amputation. Results The mean follow-up time was 5.3 years, during which time 16 amputations occurred (0.17/1000 person-years). Multivariate Cox regression analysis showed that age (hazard ratio [HR] 1.09 [95% confidence intervals] 1.02–1.16, p = 0.01) and HbA1c (HR 1.46 [1.17–1.81], p < 0.01) were independently associated with amputations. Compared with those aged < 60 years with HbA1c < 8.0%, the HR for amputation was 27.81 (6.54–118.23) in those aged ≥60 years and HbA1c ≥8.0%. Conclusions Age and HbA1c were associated with amputations among diabetic individuals, and the rates of amputation were significantly greater in those ≥60 years old and with HbA1c ≥8.0%. Supplementary Information The online version contains supplementary material available at 10.1186/s13047-021-00474-8.
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Affiliation(s)
- Masanori Kaneko
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan.
| | - Mayuko Yamada Harada
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Taeko Osawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Masahiko Yamamoto
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Masaru Kitazawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Yasuhiro Matsubayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Takaho Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | | | - Satoru Kodama
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
| | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, 1-754 Asahimachi, Niigata, Niigata, 951-8510, Japan
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Umatani N, Arai R, Kuriyama S, Matsuda S. Anatomic limitations of biceps tenodesis using an interference screw for Asian people: a cadaveric study. JSES Int 2020; 4:422-426. [PMID: 32939462 PMCID: PMC7479053 DOI: 10.1016/j.jseint.2020.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background Biceps tenodesis using an interference screw has been commonly performed in clinical practice because of pathologic changes. Especially, the tenodesis distal to the bicipital groove, such as suprapectoral tenodesis (SPT) and subpectoral tenodesis (SBT), has been performed to avoid residual anterior shoulder pain. However, the techniques were developed based on research tested on Western population, and it is unknown whether they are applicable to Asian individuals, who have a smaller humerus than Western. The purpose of this study was to investigate the anatomic limitations of the biceps tenodesis using an interference screw for Asians. Methods We analyzed 22 fixed Japanese cadavers. We measured the length of the suprapectoral tenodesis zone (STZ), which is the area from the distal end of the lesser tuberosity to the proximal border of the insertion of the pectoralis major muscle tendon (PMMT) along the course of the biceps tendon, for the SPT. We also measured the bone tunnel depths (BTDs) for the SPT just distal to the lesser tuberosity along the course of the biceps tendon and, similarly, for the SBT just distal to the PMMT insertion. Finally, we analyzed the sexual differences and correlations of the measured values with the entire humeral length. Results In 9 shoulders (40.9%), the proximal border of the PMMT insertion was attached more proximally than the distal end of the lesser tuberosity, and the length of the STZ was negative. The mean BTDs in the SPT and SBT zones were 19.6 and 14.9 mm, respectively. In 11 shoulders (50%), the BTD in the SBT zone was shorter than 15 mm. The lengths of the STZ or BTDs in the SPT and SBT zones did not show statistical differences between sexes and were not correlated with the entire humeral length. Conclusion Asian patients would have anatomic limitations as follows for the biceps tenodesis regardless of their sex or body size. In anomalous PMMT cases, when the SPT was performed just proximal to the PMMT insertion, the bone tunnel entered into the bicipital groove. On the other hand, when the SPT was performed distal to the lesser tuberosity, a part of the PMMT insertion would be injured. Regarding the SBT, an interference screw with a length of ≥12 mm, which is commonly used in Western countries, is too long for Asians.
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Affiliation(s)
- Naoki Umatani
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Ryuzo Arai
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shinichi Kuriyama
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine and Faculty of Medicine, Kyoto University, Kyoto, Japan
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Takeshita A, Watanabe H, Yamada C, Nadarajan VS, Permpikul P, Sinkitjasub A, Natalie CPH, Zhao S, Han KS, Kim DW, Suh JS, Kim HO, Kawabata K, Ishimaru K, Ohtomo N, Yamada N, Tomoda Y, Yurugi K, Ohto H. Erythrocyte Alloimmunity and Genetic Variance: Results from the Collaborative Study of Alloimmunity to Antigen Diversity in Asian Populations (All ADP). Transfus Apher Sci 2020; 59:102944. [PMID: 33228922 DOI: 10.1016/j.transci.2020.102944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
As an East-Asian international study, we evaluated erythrocyte alloimmunity by gender and history of transfusion or pregnancy. In total, data from more than 1,826,000 patients were analyzed, from whom 26,170 irregular erythrocyte antibodies were detected in 22,653 cases. Antibody frequencies in these cases were as follows: anti-E, 26.8%; anti-Lea, 20.0%; anti-P1, 7.1%; anti-M, 6.4%; anti-Mia, 5.6%; anti-c + E, 5.6%; anti-Leb, 4.6%; anti-D, 2.8%; anti-Fyb, 2.6%; anti-Lea+Leb, 2.5%; anti-Dia, 2.0%; and others. For pregnant patients, anti-D (12.7%) was statistically more frequent. For transfused patients, anti-E (37.3%), anti-c + E (9.5%), anti-C + e (3.3%) and anti-Jka (3.1%) were significantly more frequent.
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Affiliation(s)
- Akihiro Takeshita
- Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Japan.
| | - Hiroko Watanabe
- Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Chiaki Yamada
- Transfusion and Cell Therapy, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | | | - Parichart Permpikul
- Transfusion Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Attapong Sinkitjasub
- Blood Bank, Taksin Hospital, Medical Service Department of Bangkok Metropolitan, Bangkok, Thailand
| | - Chan Pui Ha Natalie
- Blood Bank, Prince of Wales Hospital, Hong Kong Special Administrative Region
| | - Shuming Zhao
- Transfusion Medicine, Southwest Hospital, Third Military Medical University, Chongqing, China
| | | | - Dae Won Kim
- Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Soul, South Korea
| | - Jang Soo Suh
- Laboratory Medicine, Kyungpook National University Hospital, Kyungpook National University, School of Medicine, Daegu, South Korea
| | - Hyun Ok Kim
- Laboratory Medicine, Yonsei University College of Medicine, Soul, South Korea
| | - Kinuyo Kawabata
- Blood Transfusion and Transplantation Immunology, Fukushima Medical University, Fukushima, Japan
| | - Ken Ishimaru
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
| | - Naoki Ohtomo
- Center for Transfusion Medicine and Cell Therapy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Naotomo Yamada
- Department of Transfusion Medicine, Saga University, Saga, Japan
| | - Yutaka Tomoda
- Laboratory Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Kimiko Yurugi
- Clinical Laboratory, Kyoto University Hospital, Kyoto, Japan
| | - Hitoshi Ohto
- Blood Service Headquarters, Japanese Red Cross Society, Tokyo, Japan
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12
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Xiong Z, Jiang Z, Liu K. Midline Volume Filler Injection for Facial Rejuvenation and Contouring in Asians. Aesthetic Plast Surg 2019; 43:1624-1634. [PMID: 31531699 DOI: 10.1007/s00266-019-01498-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/31/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Hyaluronic acid (HA) injection is popular in cosmetic surgery because of its minimal invasion and immediate recovery. However, few injection techniques are specifically designed for Asians, considering their aesthetic and structural differences from those of Caucasians. METHODS The midline volume injection technique was performed on 37 Asian females and 3 males at sites including the forehead, glabella, nasal dorsum, nasal base and chin. The treatment focused on improving the facial profile projection. 3D image data were collected, and facial aesthetic angles were calculated. Volume changes in facial parts were analyzed before injection and during follow-up. Patient satisfaction was assessed using the visual analog scale (VAS). RESULTS The average injected filler volume was 6.14 ± 2.82 ml. The treatment optimized the facial contour and produced instant facial rejuvenation. On 3D images, the average midline volume increased by 6.02 ± 2.23 ml. An average volume decrease of 3.92 ± 1.94 ml was observed in the cheeks and was positively related to the increased midline volume. The average nasolabial and nasal facial angles were increased from 100.00 ± 7.37° to 107.93 ± 9.01° and 28.78 ± 3.28° to 31.78 ± 2.97°, while the mentolabial angle was decreased from 146.55 ± 7.83° to 141.13 ± 6.23°. The mean VAS scores were 2.28 ± 1.27 immediately after injection and 2.56 ± 1.20 after 6 months. CONCLUSIONS The midline volume injection technique of HA fillers is suitable for Asians. It greatly enhances the facial profile, as illustrated by volume changes in 3D images, leading to a more attractive facial appearance. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Abstract
This article explores how six Pakistani Muslim women interpret cultural concepts of izzat (honor and self-respect); what role, if any, it has in their lives; and whether there is interplay between upholding izzat and the participants' help-seeking strategies for mental health and well-being. Semistructured interviews were conducted and analyzed with an interpretative phenomenological analytic framework. Three themes were identified: (a) "the rules of izzat," (b) "negotiating tensions," and (c) "speaking out/breaking the 'rules.'" Findings highlighted new insights into the understanding of izzat and the implications these cultural concepts have for strategies in managing or silencing of psychological distress. Interviews illustrated tensions the participants experience when considering izzat, how these are negotiated to enable them to self-manage or seek help, and possible life experiences that might lead to self-harm and attempted suicide. Notably, cultural codes, in particular izzat, appear to vary over the life course and are influenced by migration.
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Affiliation(s)
| | | | - Jane Lawrence
- 2 University of East Anglia, Norwich, United Kingdom
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Gao Y, Niddam J, Noel W, Hersant B, Meningaud JP. Comparison of aesthetic facial criteria between Caucasian and East Asian female populations: An esthetic surgeon's perspective. Asian J Surg 2016; 41:4-11. [PMID: 27630035 DOI: 10.1016/j.asjsur.2016.07.007] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/30/2016] [Accepted: 06/02/2016] [Indexed: 10/21/2022] Open
Abstract
Objective aesthetic criteria are important for patient evaluation and analysis during aesthetic surgeries, while successful aesthetic surgeries must take into account the underlying ethnic differences. The aim of this study is to help surgeons and scientists better plan facial aesthetic surgeries and understand the aesthetic needs according to different patients by reviewing and comparing the current aesthetic principles and preferences in Caucasian and East Asian populations. PubMed and The Cochrane Library were searched using keywords regarding anthropometric measurements. Only original clinical studies and reviews written in English and Chinese and those that focused on the objective assessment of facial aesthetics in Caucasian and East Asian female populations were retained for review. Reference lists of the selected articles were also reviewed for eligible studies. Sixty-five articles that described objective aesthetic criteria in Caucasian and East Asian female populations were found through PubMed, among which 47 included Caucasian populations and 18 included East Asian populations. Compared with White women, East Asian women prefer a small, delicate, and less robust face, lower position of double eyelid, more obtuse nasofrontal angle, rounder nose tip, smaller tip projection, and slightly more retruded mandibular profile. Various differences exist between objective facial aesthetic criteria in Caucasian and East Asian populations. Further studies that focus on the objective aesthetic criteria of facial attractiveness in different ethnicities need to be conducted, especially in Asian countries. Level V: Opinions of respected authorities, based on clinical experience, descriptive studies, or reports of expert committees.
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Affiliation(s)
- Y Gao
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France; Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - J Niddam
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France.
| | - W Noel
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - B Hersant
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
| | - J P Meningaud
- Department of Plastic and Reconstructive Surgery, Henri Mondor Hospital, Créteil, France
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