Prevalence of undiagnosed hyperglycemia and hypertension among middle-aged adults in Vietnam: A community-based study

Background: The information on prevalence of undiagnosed hyperglycemia, and hypertension among the adult in Vietnam is limited. The aim of this study was to identify the prevalence of undiagnosed intermediate hyperglycemia, hyperglycemia, and hypertension and some associated factors among adults aged ≥40 years living in Ba Vi district in Hanoi, Vietnam. Methods: A cross-sectional study was conducted among 1814 adults aged ≥40 years nine communes in Ba Vi district, a semi rural area, in Hanoi, Vietnam. Lists of the adults aged ≥40 years living in nine communes, who reported undiagnosed for hypertension, and diabetes, were made. From the lists, the participants were randomly selected based on the selection criteria. Participants were people who reported they are free of hypertension, diabetes, prediabetes at the day of data collection. Participants were collected information on sociodemographic characteristics, blood pressure measurement, and 3 ml fasting venous blood samples by certified phlebotomists. The main study outcomes variables were intermediate hyperglycemia, hyperglycemia, and hypertension. Results: Prevalence of undiagnosed intermediate hyperglycemia, hyperglycemia, and hypertension among the participants were 47.8 %, 8.2 %, and 40.0 %, respectively. Higher prevalence of undiagnosed intermediate hyperglycemia (53.3 % vs 46.2 %), hyperglycemia (13.5 % vs 7.9 %), and high blood pressure (52.8 % vs 33.9 %) were found among males compared with females. Conclusion: High prevalence of undiagnosed intermediate hyperglycemia, hyperglycemia, and hypertension were found in the middle-aged adults in Vietnam. Improving the individual's awareness and early screening for diabetes, and hypertension in adults for timely management are necessary

Fast Track Algorithm: How To Differentiate A “Scleroderma Pattern” From A “Non-Scleroderma Pattern”

Objectives: This study was designed to propose a simple “Fast Track algorithm” for capillaroscopists of any level of experience to differentiate “scleroderma patterns” from “non-scleroderma patterns” on capillaroscopy and to assess its inter-rater reliability. Methods: Based on existing definitions to categorise capillaroscopic images as “scleroderma patterns” and taking into account the real life variability of capillaroscopic images described standardly according to the European League Against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases, a fast track decision tree, the “Fast Track algorithm” was created by the principal expert (VS) to facilitate swift categorisation of an image as “non-scleroderma pattern (category 1)” or “scleroderma pattern (category 2)”. Mean inter-rater reliability between all raters (experts/attendees) of the 8th EULAR course on capillaroscopy in Rheumatic Diseases (Genoa, 2018) and, as external validation, of the 8th European Scleroderma Trials and Research group (EUSTAR) course on systemic sclerosis (SSc) (Nijmegen, 2019) versus the principal expert, as well as reliability between the rater pairs themselves was assessed by mean Cohen's and Light's kappa coefficients. Results: Mean Cohen's kappa was 1/0.96 (95% CI 0.95-0.98) for the 6 experts/135 attendees of the 8th EULAR capillaroscopy course and 1/0.94 (95% CI 0.92-0.96) for the 3 experts/85 attendees of the 8th EUSTAR SSc course. Light's kappa was 1/0.92 at the 8th EULAR capillaroscopy course, and 1/0.87 at the 8th EUSTAR SSc course. C Conclusion: For the first time, a clinical expert based fast track decision algorithm has been developed to differentiate a “non-scleroderma” from a “scleroderma pattern” on capillaroscopic images, demonstrating excellent reliability when applied by capillaroscopists with varying levels of expertise versus the principal expert and corroborated with external validation.Wo