- Email: [email protected]
Evaluation of the management of hypertension: the experience of a Moroccan hospital
ISMH Congress 2011 Abstracts Abstract ID: #0011 IMPACT OF DIABETES MELLITUS AND GENDER ON EXERCISERELATED ANTIANGIOGENIC ENDOSTATIN/COLLAGEN XVIII RELEASE M. Sponder ∗ , B. Stanek, A. Kautzky-Willer, R. Marculescu, S. Kampf, A. Sabri, J. Strametz-Juranek, L. Kosi Medical University of Vienna, Vienna, Austria Background: Type 2 diabetes mellitus (T2DM) is an important risk factor for cardiovascular diseases in men, resulting in endothelial dysfunction and subsequent atherosclerosis. However, the cardiovascular risk is lower in diabetic men compared to diabetic women. Endostatin (Endo) induces inhibition of proliferation and migration of endothelial cells and stimulation of endothelial nitric oxide synthase (e-NOS) and contributes to the beneficial vasoprotective effects of physical exercise in young, healthy men. Therefore the aim of the study was to investigate the impact of gender and diabetes on exercise-related Endo-release.
Results: Diabetics had higher Endo-serum levels at rest compared to healthy controls, however, female diabetics had the highest baseline levels (150.8 ng/ml) compared to healthy male (93.4 ng/ml) and female (89.3 ng/ml) controls as well as to male diabetics (108.5 ng/ml). There was no difference due to gender in the healthy control group with regard to Endo-baseline levels (89.3 ng/ml (females) versus 93.4 ng/ml (males)) or the exercise-related Endo-levels (112.1 ng/ml versus 114.8 ng/ml). In all groups there was a significant exercise-related increase in ENDO-serum levels (P-values <0.01), however in male (10.2%) and female (9.9%) probands suffering from T2DM this increase was reduced, when compared to young healthy non-smoking male (34.6%) and female (22.9%) controls. Conclusion: Elevated Endo-baseline levels in diabetics could be interpreted as a protective adaptive mechanism of the circulatory system to slow down the progression of angiogenesis and atherosclerosis. The blunted exercise-related Endo-release in diabetic men may, therefore, represent an impaired adaptive capacity of the vascular endothelium to exerciserelated stress and increased oxygen consumption. Thus, impaired Endorelease may be the missing link to impaired endothelial function and advanced progression of atherosclerosis in diabetic individuals.
Figure: Baseline and stress ENDO levels. Materials & Methods: A total of 64 patients, divided into Type 2 diabetics (14 male; 11 female, mean age 58.5 years) and young healthy non-smokers (19 male; 20 female; mean age 23.1), were investigated during a graded physical stress test. We used venous blood samples for the deterioration of Endo, which was measured (ng/ml, using ELISA) at baseline and at peak work-load. Furthermore, heart rate, BMI and blood pressure were measured (data not shown).
Table
Female yhns
Male yhns
Female T2DM
MaleT2DM
basicEndo stressEndo Increase (%) p-value
89,3 ± 15,3 112,1 ± 26,1 22,8(34,6%) <0,01
93,4 ± 15 114,8 ± 20,7 21,4(22,9%) <0,01
150,8 ± 41 155,7 ± 48.3 14,9(9,9%) 0,008
108,5 ± 17,4 119,6 ± 15,8 11,1(10,2%) 0,003
Table: ENDO levels. doi:10.1016/j.jomh.2011.08.074
Abstract ID: #0013 Topic: Non-Urology/Hypertension
EVALUATION OF THE MANAGEMENT OF HYPERTENSION: THE EXPERIENCE OF A MOROCCAN HOSPITAL N. Mouine, M. Raissouni, A. Bouzerda, M. Sabry, A. Chaib, A. Boukili, M. Nazzi, A. Benyass, E.M. Zbir ∗ Department of Cardiology, Rabat, Morocco Background: Hypertension is a major risk factor for ischemic heart disease. The aim of our study was to evaluate the therapeutic goals of antihypertensive treatment and appreciate its efficacy. Materials & Methods: This was a prospective study, carried out from January 2010 to October 2010 on a representative sample of 134 patients checked for hypertension. Patients with secondary hypertension, pregnancy hypertension and hypertensive emergencies were excluded. All subjects benefited from a complete clinical examination, blood pressure measurement, tests recommended by the WHO, an electrocardiogram, an echocardiography, ultrasonography of the supra-aortic and lower limb vessels and coronary angiography depending on the indications.
232 jmh
Vol. 8, No. 3, pp. 208–245, 2011
ISMH Congress 2011 Abstracts Results: Subjects were 73 men and 61 women with an average age of 57.8 ± 9.53 years. The majority of patients had more than 2 cardiovascular risk factors. Hypertension was classified as mild in 51%, moderate in 39% and severe in 10% of the subjects. It was complicated by nephropathy in 15%, retinopathy in 23% and cerebrovascular events in 18%. As well as antihypertensive therapy, 63% of patients went on a low-salt diet, 46% had regular physical activity, and 47% stopped smoking. After 3 months of treatment and depending on the level of hypertension, 58% of the treated patients were well versus 42% who were not. Conclusion: Hypertension treatment is well established under various guidelines, however the lifestyle change is very important and the prescription of antihypertensive drugs is essential if more patients undergoing treatment are to get well. doi:10.1016/j.jomh.2011.08.075
Abstract ID: #0100 Topic: Non-Urology/Lifestyle Issues (smoking, alcohol, drug abuse, men and their weight, sport injury, the violent man)
KICKING THE HABIT; A BIOPSYCHOSOCIAL ACCOUNT OF ENGAGING MEN RECOVERING FROM DRUG MISUSE IN REGULAR RECREATIONAL FOOTBALL K. Dunn ∗ , B. Drust, D. Flower, D. Richardson John Moores University, Liverpool, United Kingdom Background: Latest findings reveal that 7.3% of men (aged 16–59 years) in the UK currently use illegal drugs (Hoare & Moon, 2010). Drug misuse can have severe adverse health and social consequences (WHO, 2004). Participation in regular physical activity can aid recovery from substance misuse (Terry-McElrath et al, 2011). This study explored the biological, psychological and social effects of engaging men recovering from drug misuse in regular physical activity through a Football in the Community programme at an English Premier League Football Club. Materials & Methods: 9 men (mean ± SD: age 34 ± 10 years, height 1.75 ± 0.16m, mass 78.0 ± 16.5kg) recovering from drug misuse engaged in a 12 week programme consisting of 4 hours of football training per week. Indices of health and fitness (body composition, blood pressure, resting heart rate and intermittent endurance) and psychological wellbeing were measured pre and post intervention. A practitioner-cumresearcher role was adopted to include immersion in the planning and delivery of the programme. Social issues were discussed with participants through informal client–researcher interactions and data were collated through field notes, observations and personal reflections. Results: Intermittent endurance performance increased 117% from 1220 ± 114m to 2650 ± 1004m. Total body mass, fat mass and % fat decreased from 78.0 ± 16.5kg; 16.3 ± 6.6kg; 21.5 ± 5.1% to 74.9 ± 15.2kg; 13.1 ± 6.6 kg and 17.8 ± 5.2%, respectively, while lean muscle mass also increased (48.5 ± 23.4 kg to 55.6 ± 10.7kg). No real changes were observed in bone mineral density, blood pressure or resting heart rate. Positive changes were recorded and observed in participants’ self-efficacy and attitude toward their health. Participants expressed that the programme provided structure to their otherwise chaotic lives. Positive developments in social capital were also evidenced within the programme as the participants appeared to develop aspects of social bonding. Conclusion: Participation in regular recreational football can considerably improve the overall health, fitness and psychological wellbeing of men recovering from drug misuse. Furthermore, this research highlights underlying benefits of regular physical activity for this population such as its importance in the development of structure and social capital. doi:10.1016/j.jomh.2011.08.076
Abstract ID: #0094 LIFESTYLE AND NUTRITION PECULIARITIES AS RISK FACTORS FOR PRECANCEROUS SKIN LESIONS AND PREMATURE SKIN AGEING IN LATVIAN CITIZENS J. Janovska 1,∗ , J. Voicehovska 2 1
Latvian University, Riga, Latvia, 2 Riga Stradins University, LV1010, Latvia
Background: There are many risk factors for developing skin malignancy and premature skin ageing, such as ultraviolet radiation (UV), smoking, and a lot of other harmful factors, which can damage the skin esthetically as well as functionally. Our aim was to analyze the main risk factors for the development of precancerous skin lesions, to identify factors which impact on premature skin ageing in young adult Latvian citizens, aged from 16–40 years, by investigating their life habits and attitudes towards tanning facilities and a healthy lifestyle. Materials & Methods: This prospective randomized study took place at a clinic of esthetic dermatology in Riga, Latvia. In total 35 patients in the 16–40 year age group were included. We interweaved and objectively inspected this group of patients. Inspection included such components as: state of skin; patient’s phototype by Fitzpatrick scale; intensity of skin pigmentation; existence of telangiectasia on facial skin and its intensity. Seborrheic keratosis and skin dryness level were also obtained. We analyzed any interconnections between risk factors and skin precancerous lesions on the body, such as actinic keratosis. All data were analyzed using Excel and SPSS 16.0 for Windows. Results: The main risk factors in this group of young adults were: smoking, 25.7%; past history of sunburn, 54.3%; and use of indoor tanning facilities, 45.7%. We found that 22. 9% of patients did not use any kind of sunscreen. In terms of education level, 51.4% of participants had attended higher education, and 31% had a secondary level education. Therefore, level of education impacts on tanning facilities in men, as well as smoking, which is an inseparable part of the tanning habit for women. In conclusion, the main risk factors for premature skin ageing and developing skin cancer are: age (P < 0.001), use of indoor tanning facilities (P = 0.002), chronic disease (P = 0,010). Conclusion: Most of the alterations found on photo-aged skin were previously considered to be caused by UV wavelengths. Seborreic keratosis increases beyond solarium visiting, as well as lentigo type pigmentation; and the hands and back are impacted in particular. doi:10.1016/j.jomh.2011.08.077
Abstract ID: #0068 A COMMUNITY SURVEY OF YOUNG ADULTS USING RECREATIONAL KETAMINE S.K. Mak 1,∗ , K.H.S. Yip 1 , C.Y. Man 2 1
Chinese University of Hong Kong, Hong Kong, China, Hong Kong, China
2
North District Hospital,
Background: A multidisciplinary outreach volunteer clinic was set up in community centers to assess the physical, psychological and urological status of teenagers with a history of ketamine abuse. Materials & Methods: 66 teenagers, aged 13–25 years, were recruited and assessed in 6 clinic sessions from July–September 2009. Urological assessment included self-completion questionnaires on pelvic-pain, urgency and frequency (PUF), uro-flowmetry, post-void bladder scan and kidney ultrasonography. Physical fitness and cognitive function were assessed by physiotherapists. Mood and anxiety disorders were assessed using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), both self-completion questionnaires. The amount of ketamine usage was estimated from the weight of table salt using an electronic balance. The ketamine dose per week was calculated as the weight of table salt in grams multiplied by the frequency of ketamine usage per week. Results: 24% of the subjects were female. First drug abuse was as early as age 10 and 77% reported recreation as the main reason for drug abuse. The commonest drug being abused was ketamine (>97%) followed by nimetazepam (51%), cocaine (45.7%) and cannabis (39.4%). Ketamine abuse for more than 24 months was observed to have a higher PUF symptom score (6.16 vs 3.92; P = 0.043) and bother score (2.68 vs 1.42;
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2011
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Results: Diabetics had higher Endo-serum levels at rest compared to healthy controls, however, female diabetics had the highest baseline levels (150.8 ng/ml) compared to healthy male (93.4 ng/ml) and female (89.3 ng/ml) controls as well as to male diabetics (108.5 ng/ml). There was no difference due to gender in the healthy control group with regard to Endo-baseline levels (89.3 ng/ml (females) versus 93.4 ng/ml (males)) or the exercise-related Endo-levels (112.1 ng/ml versus 114.8 ng/ml). In all groups there was a significant exercise-related increase in ENDO-serum levels (P-values <0.01), however in male (10.2%) and female (9.9%) probands suffering from T2DM this increase was reduced, when compared to young healthy non-smoking male (34.6%) and female (22.9%) controls. Conclusion: Elevated Endo-baseline levels in diabetics could be interpreted as a protective adaptive mechanism of the circulatory system to slow down the progression of angiogenesis and atherosclerosis. The blunted exercise-related Endo-release in diabetic men may, therefore, represent an impaired adaptive capacity of the vascular endothelium to exerciserelated stress and increased oxygen consumption. Thus, impaired Endorelease may be the missing link to impaired endothelial function and advanced progression of atherosclerosis in diabetic individuals.
Figure: Baseline and stress ENDO levels. Materials & Methods: A total of 64 patients, divided into Type 2 diabetics (14 male; 11 female, mean age 58.5 years) and young healthy non-smokers (19 male; 20 female; mean age 23.1), were investigated during a graded physical stress test. We used venous blood samples for the deterioration of Endo, which was measured (ng/ml, using ELISA) at baseline and at peak work-load. Furthermore, heart rate, BMI and blood pressure were measured (data not shown).
Table
Female yhns
Male yhns
Female T2DM
MaleT2DM
basicEndo stressEndo Increase (%) p-value
89,3 ± 15,3 112,1 ± 26,1 22,8(34,6%) <0,01
93,4 ± 15 114,8 ± 20,7 21,4(22,9%) <0,01
150,8 ± 41 155,7 ± 48.3 14,9(9,9%) 0,008
108,5 ± 17,4 119,6 ± 15,8 11,1(10,2%) 0,003
Table: ENDO levels. doi:10.1016/j.jomh.2011.08.074
Abstract ID: #0013 Topic: Non-Urology/Hypertension
EVALUATION OF THE MANAGEMENT OF HYPERTENSION: THE EXPERIENCE OF A MOROCCAN HOSPITAL N. Mouine, M. Raissouni, A. Bouzerda, M. Sabry, A. Chaib, A. Boukili, M. Nazzi, A. Benyass, E.M. Zbir ∗ Department of Cardiology, Rabat, Morocco Background: Hypertension is a major risk factor for ischemic heart disease. The aim of our study was to evaluate the therapeutic goals of antihypertensive treatment and appreciate its efficacy. Materials & Methods: This was a prospective study, carried out from January 2010 to October 2010 on a representative sample of 134 patients checked for hypertension. Patients with secondary hypertension, pregnancy hypertension and hypertensive emergencies were excluded. All subjects benefited from a complete clinical examination, blood pressure measurement, tests recommended by the WHO, an electrocardiogram, an echocardiography, ultrasonography of the supra-aortic and lower limb vessels and coronary angiography depending on the indications.
232 jmh
Vol. 8, No. 3, pp. 208–245, 2011
ISMH Congress 2011 Abstracts Results: Subjects were 73 men and 61 women with an average age of 57.8 ± 9.53 years. The majority of patients had more than 2 cardiovascular risk factors. Hypertension was classified as mild in 51%, moderate in 39% and severe in 10% of the subjects. It was complicated by nephropathy in 15%, retinopathy in 23% and cerebrovascular events in 18%. As well as antihypertensive therapy, 63% of patients went on a low-salt diet, 46% had regular physical activity, and 47% stopped smoking. After 3 months of treatment and depending on the level of hypertension, 58% of the treated patients were well versus 42% who were not. Conclusion: Hypertension treatment is well established under various guidelines, however the lifestyle change is very important and the prescription of antihypertensive drugs is essential if more patients undergoing treatment are to get well. doi:10.1016/j.jomh.2011.08.075
Abstract ID: #0100 Topic: Non-Urology/Lifestyle Issues (smoking, alcohol, drug abuse, men and their weight, sport injury, the violent man)
KICKING THE HABIT; A BIOPSYCHOSOCIAL ACCOUNT OF ENGAGING MEN RECOVERING FROM DRUG MISUSE IN REGULAR RECREATIONAL FOOTBALL K. Dunn ∗ , B. Drust, D. Flower, D. Richardson John Moores University, Liverpool, United Kingdom Background: Latest findings reveal that 7.3% of men (aged 16–59 years) in the UK currently use illegal drugs (Hoare & Moon, 2010). Drug misuse can have severe adverse health and social consequences (WHO, 2004). Participation in regular physical activity can aid recovery from substance misuse (Terry-McElrath et al, 2011). This study explored the biological, psychological and social effects of engaging men recovering from drug misuse in regular physical activity through a Football in the Community programme at an English Premier League Football Club. Materials & Methods: 9 men (mean ± SD: age 34 ± 10 years, height 1.75 ± 0.16m, mass 78.0 ± 16.5kg) recovering from drug misuse engaged in a 12 week programme consisting of 4 hours of football training per week. Indices of health and fitness (body composition, blood pressure, resting heart rate and intermittent endurance) and psychological wellbeing were measured pre and post intervention. A practitioner-cumresearcher role was adopted to include immersion in the planning and delivery of the programme. Social issues were discussed with participants through informal client–researcher interactions and data were collated through field notes, observations and personal reflections. Results: Intermittent endurance performance increased 117% from 1220 ± 114m to 2650 ± 1004m. Total body mass, fat mass and % fat decreased from 78.0 ± 16.5kg; 16.3 ± 6.6kg; 21.5 ± 5.1% to 74.9 ± 15.2kg; 13.1 ± 6.6 kg and 17.8 ± 5.2%, respectively, while lean muscle mass also increased (48.5 ± 23.4 kg to 55.6 ± 10.7kg). No real changes were observed in bone mineral density, blood pressure or resting heart rate. Positive changes were recorded and observed in participants’ self-efficacy and attitude toward their health. Participants expressed that the programme provided structure to their otherwise chaotic lives. Positive developments in social capital were also evidenced within the programme as the participants appeared to develop aspects of social bonding. Conclusion: Participation in regular recreational football can considerably improve the overall health, fitness and psychological wellbeing of men recovering from drug misuse. Furthermore, this research highlights underlying benefits of regular physical activity for this population such as its importance in the development of structure and social capital. doi:10.1016/j.jomh.2011.08.076
Abstract ID: #0094 LIFESTYLE AND NUTRITION PECULIARITIES AS RISK FACTORS FOR PRECANCEROUS SKIN LESIONS AND PREMATURE SKIN AGEING IN LATVIAN CITIZENS J. Janovska 1,∗ , J. Voicehovska 2 1
Latvian University, Riga, Latvia, 2 Riga Stradins University, LV1010, Latvia
Background: There are many risk factors for developing skin malignancy and premature skin ageing, such as ultraviolet radiation (UV), smoking, and a lot of other harmful factors, which can damage the skin esthetically as well as functionally. Our aim was to analyze the main risk factors for the development of precancerous skin lesions, to identify factors which impact on premature skin ageing in young adult Latvian citizens, aged from 16–40 years, by investigating their life habits and attitudes towards tanning facilities and a healthy lifestyle. Materials & Methods: This prospective randomized study took place at a clinic of esthetic dermatology in Riga, Latvia. In total 35 patients in the 16–40 year age group were included. We interweaved and objectively inspected this group of patients. Inspection included such components as: state of skin; patient’s phototype by Fitzpatrick scale; intensity of skin pigmentation; existence of telangiectasia on facial skin and its intensity. Seborrheic keratosis and skin dryness level were also obtained. We analyzed any interconnections between risk factors and skin precancerous lesions on the body, such as actinic keratosis. All data were analyzed using Excel and SPSS 16.0 for Windows. Results: The main risk factors in this group of young adults were: smoking, 25.7%; past history of sunburn, 54.3%; and use of indoor tanning facilities, 45.7%. We found that 22. 9% of patients did not use any kind of sunscreen. In terms of education level, 51.4% of participants had attended higher education, and 31% had a secondary level education. Therefore, level of education impacts on tanning facilities in men, as well as smoking, which is an inseparable part of the tanning habit for women. In conclusion, the main risk factors for premature skin ageing and developing skin cancer are: age (P < 0.001), use of indoor tanning facilities (P = 0.002), chronic disease (P = 0,010). Conclusion: Most of the alterations found on photo-aged skin were previously considered to be caused by UV wavelengths. Seborreic keratosis increases beyond solarium visiting, as well as lentigo type pigmentation; and the hands and back are impacted in particular. doi:10.1016/j.jomh.2011.08.077
Abstract ID: #0068 A COMMUNITY SURVEY OF YOUNG ADULTS USING RECREATIONAL KETAMINE S.K. Mak 1,∗ , K.H.S. Yip 1 , C.Y. Man 2 1
Chinese University of Hong Kong, Hong Kong, China, Hong Kong, China
2
North District Hospital,
Background: A multidisciplinary outreach volunteer clinic was set up in community centers to assess the physical, psychological and urological status of teenagers with a history of ketamine abuse. Materials & Methods: 66 teenagers, aged 13–25 years, were recruited and assessed in 6 clinic sessions from July–September 2009. Urological assessment included self-completion questionnaires on pelvic-pain, urgency and frequency (PUF), uro-flowmetry, post-void bladder scan and kidney ultrasonography. Physical fitness and cognitive function were assessed by physiotherapists. Mood and anxiety disorders were assessed using the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), both self-completion questionnaires. The amount of ketamine usage was estimated from the weight of table salt using an electronic balance. The ketamine dose per week was calculated as the weight of table salt in grams multiplied by the frequency of ketamine usage per week. Results: 24% of the subjects were female. First drug abuse was as early as age 10 and 77% reported recreation as the main reason for drug abuse. The commonest drug being abused was ketamine (>97%) followed by nimetazepam (51%), cocaine (45.7%) and cannabis (39.4%). Ketamine abuse for more than 24 months was observed to have a higher PUF symptom score (6.16 vs 3.92; P = 0.043) and bother score (2.68 vs 1.42;
jmh Vol. 8, No. 3, pp. 208–245,
2011
233