The Association Between Mild Cognitive Impairment and Medication Non-adherence Among Elderly Patients With Chronic Diseases.

BACKGROUND: Medication adherence is essential for optimizing treatment outcomes in elderly patients who frequently contend with multiple chronic diseases requiring pharmacological interventions. Mild cognitive impairment (MCI) is a prevalent cognitive disorder among the elderly population, but its impact on medication adherence among elderly patients is still uncertain. This cross-sectional study aimed to investigate the impact of MCI on medication adherence among elderly patients. METHODS: A cross-sectional study of 436 elderly patients with common chronic diseases aged 60 years and above was conducted. Medication adherence was measured using the Morisky Medication Adherence Scale-8 (MMAS-8). MCI was screened, and cognitive status was assessed using the Mini-Mental State Examination (MMSE) questionnaire. Multivariate logistic regression analysis was performed to identify independent risk factors of medication non-adherence. RESULTS: Among these elderly patients, 212 (48.6%) had poor medication compliance, and 181 (41.5%) had MCI. Preliminary analyses showed a significant association between MCI and medication non-adherence among elderly patients (odds ratio (OR)=3.95, 95% confidence interval (95%CI)=2.63-5.92, P<0.001). Multivariate logistic regression analysis showed that MCI was independently associated with the risk of medication non-adherence among elderly patients (adjusted OR=2.64, 95%CI=1.64-4.24, P<0.001). Additionally, adverse drug reaction and poor evaluation of medication effects were also independently associated with medication non-adherence in elderly patients (P<0.05). CONCLUSION: Findings from this cross-sectional study proved the substantial adverse impact of MCI on medication adherence among elderly patients, and MCI was an independently influential factor of medication non-adherence. Identifying the MCI status early and providing interventions to enhance medication adherence are undoubtedly essential for optimizing healthcare outcomes in elderly patients.

Knowledge of SARS-CoV-2 antigen detection and proper use of rapid diagnostic self-test among Shanghai residents in China.

Objectives: To assess and evaluate the knowledge of Shanghai, China, residents on the use of SARS-CoV-2 antigen detection and rapid diagnostic self-test. Methods: A cross-sectional electronic survey using a self-administered questionnaire was sent via the online platform, Sojump, to general individuals. Multiple linear regression analysis was performed to determine the variables associated with knowledge of self-test. Results: A total of 283 participants were recruited between July 1, 2022 and July 20, 2022 through an online survey. The mean score of knowledge on the tests was 14.33 ± 2.85 (out of 21). The questions concerning the depth of swab insertion and minimum number of swab rotations in the nostril, necessity of bilateral sampling, necessity of rotating and squeezing the swab for 10 times in the extraction buffer tube, and waiting time for the results showed the highest rate of incorrect responses. In the multiple regression analysis model, sex, social status, and source of information were associated with the knowledge on the self-test kits. Conclusion: Immediate health education programs should be made available and the kits could be improved appropriately to ensure adequate knowledge. The use of technology should be fully leveraged to achieve accurate self-diagnosis and correct interpretation of the results.

Parental, gestational, and early-life exposure to indoor environmental hazardous factors on allergic rhinitis among preschool children in Urumqi City: a case-control study.

OBJECTIVE: Allergic rhinitis (AR) is a disease associated with impaired quality of life and heredity. This study aimed to investigate the association of allergic rhinitis in preschool children with exposure to indoor environment-related factors early in life. METHODS: In August 2019, the authors implemented a study among 2020 preschool children in Urumqi City using a case-control design. The study included parental reports for the occurrence of AR in children, parental history of respiratory disease, and indoor environmental correlates of maternal exposure from 1 year prior to pregnancy until the child's age of 0-1 year. RESULTS: Mode of birth (cesarean section) (OR = 1.31, 95% CI = 1.02∼1.67), father with AR (OR = 2.67, 95% CI = 2.08∼3.44), mother with AR (OR = 3.70, 95% CI = 2.88∼4.74), mother with asthma (OR = 3.11, 95% CI = 1.18∼8.20), and mother with newly purchased furniture in the parents' residence during pregnancy (OR = 1.49, 95% CI = 1.03∼2.14) were risk factors for AR in children. CONCLUSIONS: The focus of allergic rhinitis should be on children with a family history of AR and asthma and cesarean delivery. Primary prevention efforts for AR in preschool children are avoiding exposure of children to indoor environmental hazardous factors early in life.

Parental, gestational, and early-life exposure to indoor environmental hazardous factors on allergic rhinitis among preschool children in Urumqi City: a case-control study

Abstract Objective Allergic rhinitis (AR) is a disease associated with impaired quality of life and heredity. This study aimed to investigate the association of allergic rhinitis in preschool children with exposure to indoor environment-related factors early in life. Methods In August 2019, the authors implemented a study among 2020 preschool children in Urumqi City using a case-control design. The study included parental reports for the occurrence of AR in children, parental history of respiratory disease, and indoor environmental correlates of maternal exposure from 1 year prior to pregnancy until the child's age of 0-1 year. Results Mode of birth (cesarean section) (OR = 1.31, 95% CI = 1.02∼1.67), father with AR (OR = 2.67, 95% CI = 2.08∼3.44), mother with AR (OR = 3.70, 95% CI = 2.88∼4.74), mother with asthma (OR = 3.11, 95% CI = 1.18∼8.20), and mother with newly purchased furniture in the parents' residence during pregnancy (OR = 1.49, 95% CI = 1.03∼2.14) were risk factors for AR in children. Conclusions The focus of allergic rhinitis should be on children with a family history of AR and asthma and cesarean delivery. Primary prevention efforts for AR in preschool children are avoiding exposure of children to indoor environmental hazardous factors early in life.

Correlation between nutrition, oral health, and different sarcopenia groups among elderly outpatients of community hospitals: a cross-sectional study of 1505 participants in China.

BACKGROUND: Studies have rarely explored the association between oral health status and different sarcopenia groups (possible sarcopenia, diagnosed sarcopenia, and severe sarcopenia). Moreover, these studies have not reported any definitive conclusions of their relationship. We aimed to characterize the oral health status, prevalence of sarcopenia, and risk factors in different sarcopenia groups of elderly outpatients of community hospitals. Furthermore, we determined the correlation among nutrition, oral health, and different sarcopenia groups. METHODS: Overall, 1505 elderly participants (aged ≥ 65 years) completed the survey. The Mini Nutritional Assessment short-form (MNA-SF) was used to assess the nutrition status of the elderly. Oral health was assessed using the instrument of the oral health assessment index of the elderly (General Oral Health Assessment Index [GOHAI]), and the number of remaining natural teeth (NRT) was counted. Data on muscle mass, muscle strength, and gait speed were collected, and sarcopenia was classified into three groups (possible sarcopenia, diagnosed sarcopenia, and severe sarcopenia) according to the Asian Working Group for Sarcopenia 2019. Multinomial logistic regression multivariate analysis was used to test their relationships. RESULTS: Eighty-eight (5.8%) participants were identified as having possible sarcopenia; 142 (9.5%), diagnosed sarcopenia; 136 (9.0%), severe sarcopenia; and 1139 (75.7%), no sarcopenia. Of the seven variables, advancing age was typically associated with an increasing prevalence of sarcopenia (odds ratio [OR] = 1.06-1.47, 95% confidence interval [CI] = 1.06-1.47). The results showed that household income (OR = 0.57, 95% CI = 0.33-0.98), education level (OR = 3.32, 95% CI = 1.09-10.07), and chronic diseases (OR = 0.34, 95% CI = 0.19-0.62) were significantly associated with the severe sarcopenia group. Physical activity scores were significantly associated with the diagnosed sarcopenia and severe sarcopenia groups. Participants with < 20 NRT were more likely to have diagnosed sarcopenia (OR = 5.55, 95% CI = 3.80-8.12) or severe sarcopenia (OR = 6.66, 95% CI = 4.13-10.76) than participants with > 20 NRT. The GOHAI score was associated with the diagnosed sarcopenia (OR = 5.55, 95% CI = 3.80-8.12) and severe sarcopenia (OR = 6.66, 95% CI = 4.13-10.78) groups. The MNA-SF score was associated with the different sarcopenia groups. CONCLUSIONS: Assessing early and improving lifestyle with respect to nutrition and oral health may be an effective way to reduce or delay the occurrence of sarcopenia.

Tele-Health Intervention for Carers of Dementia Patients-A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Objective: The purpose of this study is to evaluate the major mental health outcomes on dementia patient carers when using psychoeducational programs and psychotherapeutic interventions. Methods: A meta-analysis was performed with randomized controlled trials of carers' tele-health interventions from the literature inception to December 31, 2019, using PubMed, EMBASE, and CENTRAL databases for articles. Results: The meta-analysis identified 1,043 results, of which 11 were randomized control trials. Among all 11 randomized control trials, only one study addressed face-to-face contact with online modules of interventions, four studies addressed telephone-based interventions, two studies reported on combined face-to-face contact and phone call interventions, two studies focused on web-based interventions, one study used video and telephone interventions, and one study conducted a computer-telephone integration system of intervention. The updated evidence suggested that there was more efficacy via tele-health interventions in lowering depression for carers of people with dementia. We outlined the delivery formation of intervention to evaluate the effectiveness and processes of major mental health improvements, including depression, burden, anxiety, and quality of life. Conclusions: In this study, tele-health intervention was shown to significantly lower depression and also lower the risk of mental health impairment. Although there was a significant decrease of depression, there were no significant differences in burden, anxiety, and quality of life. Future researchers are encouraged to carry out larger-scale studies; also, further analysis using a standardized assessment tool is suggested for future multi-component tele-health interventions.

MTNR1B gene on susceptibility to gestational diabetes mellitus: a two-stage hospital-based study in Southern China.

Large-scale studies on genetic risk loci for melatonin receptor 1B (MTNR1B) gene and GDM risk have not been well generalized to the Chinese population. In this study, we performed two-stage case-control study: 1.429 pregnant women: 753 GDM/676 controls in the Southern Chinese population by genotyping 5 SNPs (rs10830963, rs1387153, rs2166706, rs1447352, and rs4753426) in MTNR1B. Genotypes were determined using the Sequenom MassARRAY platform and TaqMan allelic discrimination assay. Interactions between genetic variants and age/BMI as predictors of GDM risk were evaluated under the logistic regression model. In the first stage, the SNP rs10830963 was discovered to be potentially related to GDM risk (additive model: OR = 1.27, 95%CI = 1.05-1.55, P = 0.025), which was further confirmed in the second stage with a similar effect (additive model: OR = 1.53, 95%CI = 1.19-1.98, P = 0.005). In the combined stage, the G allele of rs10830963 was potentially associated with GDM risk (additive model: OR = 1.36, 95%CI = 1.17-1.59, P < 0.001; dominant model: OR = 1.45, 95%CI = 1.15-1.83, P = 0.005). The rs10830963 interacted with age and BMI to contribute to GDM risk in the combined participants. And, the similar interactive effects for the other four SNPs also exist. These findings offer the potential to improve our understanding of the etiology of GDM, and particularly of biological mechanisms.

[The changes of mucosal mast cells and substance P in patients with irritable bowel syndrome].

OBJECTIVE: To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their possible roles in visceral hypersensitivity in patients with irritable bowel syndrome (IBS). METHODS: In 22 diarrhea-predominant IBS, 20 constipation-predominant IBS and 19 controls, the biopsies were carried out from the terminal ileum, the ileocecal junction, the ascending colon, and the sigmoid colon. The MCs and the SP-ergic nerve terminals, SP receptor (SPR) cells were stained by histochemistry and immunohistochemistry respectively, and the results were investigated qualitatively and quantitatively by color image analyzer. The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay. The structure relation between the MCs and SP-ergic terminals, SPR-ergic cells were studied through an ultramicroscopy using in situ embedding technique and a light microscopic study in serial sections respectively. RESULTS: The number of MCs in the terminal ileum, the ileocecal junction, and the ascending colon were significantly elevated in IBS patients (P < 0.01), and the MCs in IBS have great variations. Significantly increased the SP-ergic nerve terminals were found in patients with IBS of intestine compared with the control. The correlation between mucosal MC and the SP-ergic nerve terminals was found, and MCs were close to these terminals in lamina propria, which were demonstrated SP-ergic nerve terminals. Some MCs were demonstrated to be SPR-positive cells. CONCLUSIONS: The MCs and SP of intestinal mucosa may play a central role in the gut hypersensitivity in both motor response and visceral perception in IBS.