Health-risk factors and the prevalence of hypertension: cross-sectional findings from a national cohort of 87 143 Thai Open University Students

BACKGROUND: Thailand is undergoing a health-risk transition which increases chronic diseases, particularly hypertension, as a result of a rapid transition from a developing to a developed country. This study analyzes the effect of health-risk factors such as demography, socioeconomic status (SES) and body mass index (BMI) on the prevalence of hypertension. METHODS: This was a cross-sectional analysis using data obtained in 2005 from 87 143 Sukhothai Thammathirat Open University (STOU) students participating in the Thai Cohort Study (mean age 30.5 years, 54.7% female). Adjusted odds ratios of the association between risk factors and hypertension were analysed across two age groups by sex, after controlling for the confounding factors such as SES and BMI. RESULTS: The prevalence of hypertension in men was approximately twice as high as that in women (6.9% vs 2.6%). Hypertension was associated with ageing, a lower education attainment, a higher BMI and having underlying diseases in both sexes. In men, hypertension was associated with being single, having a high income, spending more time on screens (TV & PC), cigarette smoking and drinking alcohol. In women, it was directly correlated with instant and roasted or smoked food consumption. CONCLUSIONS: Hypertension was highly associated with obesity and having underlying disease. The Thai health-risk transition is in a later stage. Thais should now be educated about the danger of high blood pressure and the protective power of a low fat and low salt diet, and a normal BMI. Cessation of smoking and moderation in alcohol intake should be promoted.NHMRC (National Health and Medical Research Council of Australia

Efficacy of a trivalent influenza vaccine against seasonal strains and against 2009 pandemic H1N1: a randomized, placebo-controlled trial

Background: Before pandemic H1N1 vaccines were available, the potential benefit of existing seasonal trivalent inactivated influenza vaccines (IIV3s) against influenza due to the 2009 pandemic H1N1 influenza strain was investigated, with conflicting results. This study assessed the efficacy of seasonal IIV3s against influenza due to 2008 and 2009 seasonal influenza strains and against the 2009 pandemic H1N1 strain. Methods: This observer-blind, randomized, placebo-controlled study enrolled adults aged 18–64 years during 2008 and 2009 in Australia and New Zealand. Participants were randomized 2:1 to receive IIV3 or placebo. The primary objective was to demonstrate the efficacy of IIV3 against laboratory-confirmed influenza. Participants reporting an influenza-like illness during the period from 14 days after vaccination until 30 November of each study year were tested for influenza by real-time reverse transcription polymerase chain reaction. Results: Over a study period of 2 years, 15,044 participants were enrolled (mean age ± standard deviation: 35.5 ± 14.7 years; 54.4% female). Vaccine efficacy of the 2008 and 2009 IIV3s against influenza due to any strain was 42% (95% confidence interval [CI]: 30%, 52%), whereas vaccine efficacy against influenza due to the vaccine-matched strains was 60% (95% CI: 44%, 72%). Vaccine efficacy of the 2009 IIV3 against influenza due to the 2009 pandemic H1N1 strain was 38% (95% CI: 19%, 53%). No vaccine-related deaths or serious adverse events were reported. Solicited local and systemic adverse events were more frequent in IIV3 recipients than placebo recipients (local: IIV3 74.6% vs placebo 20.4%, p < 0.001; systemic: IIV3 46.6% vs placebo 39.1%, p < 0.001). Conclusions: The 2008 and 2009 IIV3s were efficacious against influenza due to seasonal influenza strains and the 2009 IIV3 demonstrated moderate efficacy against influenza due to the 2009 pandemic H1N1 strain

Meaningful relief with flurbiprofen 8.75\ua0mg spray in patients with sore throat due to upper respiratory tract infection

Evaluate the efficacy of flurbiprofen 8.75\ua0mg spray for sore throat relief.Randomized, double-blind study in adults with sore throat due to upper respiratory tract infection who took flurbiprofen (n\ua0=\ua0249) or placebo spray (n\ua0=\ua0256). Pain relief was assessed using the Sore Throat Relief Rating Scale.Flurbiprofen spray provided significantly greater relief versus placebo from 20\ua0min to 6\ua0h (p\ua0< 0.0001; maximum difference: 75\ua0min). Sore throat severity was reduced ≥-2.2 on the Sore Throat Scale from 75\ua0min to 6\ua0h, indicating meaningful relief. Significantly more patients taking flurbiprofen spray reported ≥30\ua0min of 'at least moderate' relief versus placebo over 6\ua0h (p\ua0< 0.0001). Most adverse events were mild.Flurbiprofen spray provides rapid, long-lasting and clinically meaningful relief from sore throat (ANZCTR: ACTRN12612000457842)

Validity of self-reported hypertension: findings from the Thai Cohort Study compared to physician telephone interview

Surveys for chronic diseases, and large epidemiological studies of their determinants, often acquire data through self-report since it is feasible and efficient. We examined validity and associations of self-reported hypertension, as verified by physician telephone interview among participants in a large ongoing Thai Cohort Study (TCS)

Efficacy and safety of beloranib for weight loss in obese adults: a randomized controlled trial

2015 John Wiley & Sons Ltd. Aim: To assess the efficacy, safety and tolerability of beloranib treatment for obesity. Methods: This phase II, double-blind, randomized study investigated the effects of beloranib suspension (0.6, 1.2 and 2.4mg) or placebo, administered subcutaneously, for 12weeks in 147 participants (primarily white women) with obesity. No diet or exercise advice was administered. Results: At week 12, beloranib resulted in dose-dependent progressive weight loss of -5.5±0.5, -6.9±0.6 and -10.9±1.1kg for the 0.6, 1.2 and 2.4mg beloranib doses, respectively, compared with -0.4±0.4kg with placebo (all p\u3c0.0001 vs placebo). Weight loss with beloranib was associated with corresponding reductions in waist circumference and body fat mass, as well as improvements in lipids, high-sensitivity C-reactive protein and blood pressure. Sleep disturbance and gastrointestinal adverse events were more common with beloranib than with placebo; these were generally mild to moderate, transient and dose-related, and led to more early study withdrawals in participants in the group with the highest dose of beloranib. Conclusions: In this 12-week phase II study, beloranib produced clinically and statistically significant weight loss and corresponding improvements in cardiometabolic risk factors. Beloranib appeared safe, and the 0.6 and 1.2mg doses were generally well tolerated. The 2.4mg dose was associated with increased sleep latency and mild to moderate gastrointestinal adverse events over the first month of treatment. These findings represent a novel mechanism for producing clinically meaningful weight loss

Efficacy of flurbiprofen 8.75 mg spray in patients with sore throat due to an upper respiratory tract infection: A randomised controlled trial

<p><b>Background:</b> Viral infections cause most cases of pharyngitis (sore throat); consequently, antibiotics are generally not warranted. However, a treatment targeting pain and inflammation, e.g. a topical non-steroidal anti-inflammatory spray, may be helpful for patients.</p> <p><b>Objective:</b> To evaluate the efficacy and safety of flurbiprofen 8.75 mg spray.</p> <p><b>Methods:</b> This randomised, double-blind, parallel group study was conducted at six community-based clinical research centres in Australia and two in New Zealand. Adults with sore throat due to upper respiratory tract infection (onset ≤ four days) took one dose of flurbiprofen (<i>n</i> = 249) or placebo spray (<i>n</i> = 256); after six hours, they could re-dose every three–six hours as required, for three days (max. five doses/day). The primary endpoint was the area under the change from baseline curve in throat soreness from zero–two hours (AUC_0–2h). The change from baseline in other sore throat symptoms also assessed efficacy.</p> <p><b>Results:</b> The mean AUC_0–2h for throat soreness was significantly greater with flurbiprofen spray (−1.82; 95% CI: −1.98 to 1.65) compared with placebo (−1.13; 95% CI: −1.27 to 0.99) (<i>P</i> < 0.0001). Significantly greater reductions from baseline were observed with flurbiprofen spray compared with placebo from the first time-points assessed (five minutes for throat soreness/difficulty swallowing, 20 minutes for sore throat pain intensity and 30 minutes for swollen throat) for up to six hours (<i>P</i> < 0.05 for all). There was no significant difference in adverse events between treatment groups during the three-day study.</p> <p><b>Conclusion:</b> Flurbiprofen spray provides rapid and long-lasting relief from sore throat symptoms, and is well-tolerated over three days.</p

More rigorous protocol adherence to intensive structured management improves blood pressure control in primary care: results from the Valsartan Intensified Primary carE Reduction of Blood Pressure study

Objective: To examine protocol adherence to structured intensive management in the Valsartan Intensified Primary carE Reduction of Blood Pressure (VIPER-BP) study involving 119 primary care clinics and 1562 randomized participants.\ud \ud Methods: Prospective criteria for assessing adherence to treatment prescription, uptitration, and visit attendance at 6, 10, 14, and 18 weeks postrandomization were applied to 1038 intervention participants. Protocol adherence scores of 1–5 (least to most adherent) were compared to blood pressure (BP) control during 26 weeks of follow-up.\ud \ud Results: Mean age was 59.3 ±12.0 years, 963 (62%) were men, and 1045 (67%) had longstanding hypertension. Clinic attendance dropped from 91 (week 6) to 83% (week 26) and pharmacological instructions were followed for 93% (baseline) to 61% at week 14 (uptitration failures commonly representing protocol deviations). Overall, 26-week BP levels and BP target attainment ranged from 132 ± 14/79 ± 9 and 51% to 141 ± 15/83 ± 11 mmHg and 19% in those participants subject to the highest (n = 270, 26%) versus least (n = 148, 14%) per protocol adherence, respectively; adjusted relative risk (RR) 1.22 per unit protocol adherence score, 95% confidence interval (CI) 1.15–1.31; for achieving BP target (P < 0.001). Participants with a per protocol score of 4 or 5 (512/1038, 49.3%) were 1.54-fold (95% CI 1.31–1.81; P < 0.001) more likely to achieve their individual BP target compared with usual care. Clinics equipped with a practice nurse significantly influenced protocol adherence (adjusted RR 1.20, 95% CI 1.06–1.37; P = 0.004) and individual BP control (RR 1.21, 95% CI 1.04–1.41; P = 0.015).\ud \ud Conclusion: There is considerable potential for structured care management to improve BP control in primary care, especially when optimally applied.\u