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1.
GERMS ; 12(2):298-303, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033515

RESUMO

Introduction COVID-19 is an emerging infectious disease that remains to be further investigated. Case report Here, we describe a case of COVID-19 in an octogenarian woman with comorbidities who slowly recovered during hospitalization, but died due to sudden cardiac death after 2 weeks of hospitalization. Her nasopharyngeal and anal swabs returned positive for SARS-CoV-2 by RT-PCR on day 7 of hospitalization. The NGS showed possible intraindividual evolution of virus. The sample from the nasopharyngeal swab yielded a B.1470 variant classified as clade GH. This variant showed mutation in the spike gene D614G;N gene;NS3 gene;NSP2 gene and NSP12 gene. The sample from the anal swab showed similar mutation but with additional point mutation in spike gene S12F and was classified as B.1.465 variant. Conclusions The possibility of the gastrointestinal tract that served as reservoir for virus mutation accumulation should also be considered and the potential impact of viral fecal transmission in the environment should be further investigated.

2.
NeuroQuantology ; 20(10):5508-5516, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033485

RESUMO

Hypovitaminosis D was shown to be prevalent in this research of 124 people who were COVID-19 positive. With a p-value of 0.001, greater serum concentrations of inflammatory markers like COVID-19 were significantly related with lower vitamin D levels (D-dimer, CRP, and ferritin). One way to gauge the severity of COVID-19 infection is by looking at the serum vitamin D level. An increased risk of acute respiratory infection is linked to vitamin D deficiency. The processes through which vitamin D influences the immune system are complex. The usual immunomodulatory activity appears to be inhibited with reduced serum vitamin D concentrations, favoring a pro-inflammatory phase. Less effective macrophage activity and antigen presentation may be caused by insufficient vitamin D levels. As a result, low vitamin D levels may potentially contribute to a delayed or dysregulated response to the body's initial contact with SARS-CoV-2 or prevent the construction of an effective defense in cases of established SARS-CoV-2 infection. Inflammation and the biological functions of the innate and adaptive immune systems are linked to vitamin D. Coronavirus illness risk or severity have been observed to be inversely correlated with blood 25-hydroxyvitamin D (25(OH)D) levels in observational studies (COVID-19). The significance of vitamin D in COVID-19 has been attributed to a number of pathways, such as the modulation of immunological and inflammatory responses, control of the renin-angiotensin-aldosterone systems, and participation in glucose metabolism and the cardiovascular system. Patients with COVID-19 may be more likely to experience catastrophic consequences if their 25(OH)D levels are low, not only because of the hyperinflammatory state that is often present but also because it aggravates cardiovascular disease and impaired glucose metabolism that already exist. Some randomized controlled trials have demonstrated that supplementing with vitamin D is helpful for lowering coronavirus 2 RNA positivity in SARS, but not for lowering intensive care unit admission or all-cause death in patients with moderate-to-severe COVID-19. According to the most recent research, taking a vitamin D supplement to keep your serum 25(OH)D level at or above 30 ng/mL (recommended range: 40–60 ng/mL) may help lower your risk of developing COVID-19 and its serious consequences, such as death. According to worldwide recommendations, it is prudent to suggest vitamin D supplements to those who have vitamin D shortage or insufficiency during the COVID-19 pandemic, even though additional well-designed research are necessary.

3.
NeuroQuantology ; 20(10):3656-3661, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033477

RESUMO

The continents have been overtaken by chaos and tragedy as COVID-19 performs its cosmic dance. In such a situation, life satisfaction indices could decline while mental stress is likely to rise. The stress and life satisfaction levels among diabetes patients were expressed using descriptive statistics. The association between perceived stress and life satisfaction was examined using the chi-square test. The number of diabetic patients at our institution who were willing to enroll was a total of 140. Participants in the research had an average age of 52.38 + 14.9 years. 46.4 percent of the study's participants were above the age of 55. There is an urgent need to introduce stress busters because half (50%) of the participants reported moderate to high levels of stress. Additionally, about 20% of the individuals reported having trouble with stress. Stress may negatively affect a diabetic patient's ability to control their blood sugar, thus therapies that reduce or manage stress may be crucial in preventing the development of major diabetes problems in the future. Keywords:.

4.
Virology Journal ; 19(1):148, 2022.
Artigo em Inglês | MEDLINE | ID: covidwho-2029723

RESUMO

BACKGROUND: Omicron variant (B.1.1.529) is a dominant variant worldwide. However, the risk factors for Omicron variant clearance are yet unknown. The present study aimed to investigate the risk factors for early viral clearance of Omicron variant in patients with a history of inactivated vaccine injection. METHODS: Demographic, clinical, and epidemiological data from 187 patients were collected retrospectively during the Omicron variant wave. RESULTS: 73/187 and 114/187 patients were administered two and three doses of vaccine, respectively. The median duration of SARS-CoV-2 RNA positivity was 9 days, and the difference between patients with two and three vaccine injections was insignificant (P = 0.722). Fever was the most common symptom (125/187), and most patients (98.4%) had a fever for < 7 days. The RNA was undetectable in 65/187 patients on day 7. Univariable logistic analysis showed that baseline glucose, uric acid, lymphocytes count, platelet count, and CD4+ T lymphocyte count were associated with SARS-CoV-2 RNA-positivity on day 7. Multivariable analysis showed that glucose >= 6.1 mmol/L and CD4+T lymphocytes count were independent risk factors for RNA positivity on day 7. 163/187 patients had an undetectable RNA test on day 14, and uric acid was the only independent risk factor for RNA positivity. Moreover, baseline glucose was negatively correlated with uric acid and CD4+ and CD8+ T cell count, while uric acid was positively correlated with CD4+ and CD8+ T cell count. CONCLUSIONS: Omicron variant clearance was delayed in breakthrough cases with elevated fasting blood glucose, irrespective of the doses of inactivated vaccine.

5.
Telehealth and Medicine Today ; 7(1), 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2026489

RESUMO

Importance: This very large claims data analysis documents widespread adoption of telehealth use by patients with diabetes during the first year of the COVID-19 pandemic, giving us insight into the potential role of telehealth as we enter a stage of “new normal” of healthcare delivery in the U.S. Objective: The COVID-19 Telehealth Impact Study was designed to describe the natural experiment of telehealth adoption during the pandemic. This focused analysis can assist program development for care of large populations of patients with diabetes. Design, Setting, Participants: In March 2020, the MITRE Corporation and Mayo Clinic founded the COVID-19 Healthcare Coalition (C19HCC) and Telehealth Impact Study to respond to the pandemic. We report trends using a data set of over 2 billion healthcare claims covering over 50% of private insurance activity in the U.S. (January 2019-March 2021). Main Outcomes and Measures: We compared rates of telehealth use in the one-year pre and one-year post onset of the COVID-19 pandemic among a population of 8,339,633 patients with diabetes. Results: Compared to a baseline of very low telehealth use in 2019, there was rapid adoption of telehealth by patients with diabetes in Spring 2020. 27% of diabetics used telehealth in Q2 2020 and use rates declined in the ensuing months to approximately 13%. Diabetics and their providers used telehealth to address a wide variety of health problems. 77% of telehealth visits addressed diabetes, 53% hypertension and over 40% of visits addressed mental and behavioral health diagnoses. Audio-only (telephone visits) accounted for a substantial portion of telehealth encounters (10.0- 16.3%) and will be an important consideration for future telehealth planning. Over the course of the first 12 months of the pandemic, 98% diabetics who used telehealth used 4 or fewer telehealth visit. Conclusions and Relevance: We believe that telehealth will quickly become a best practice for routine care of patients with diabetes and other chronic conditions. Telehealth interactions 2-4 times per year supplemented with remote monitoring for glucose, blood pressure and weight have the potential to greatly enhance patient care. Further research will be needed to measure the telehealth impact on glycemic control, patient satisfaction and other outcomes. We encourage CMS and other payers to embrace and promote use of telehealth based on this real-world experience of patients and providers during the pandemic.

6.
Haydarpasa Numune Medical Journal ; 62(2):117-122, 2022.
Artigo em Inglês | CAB Abstracts | ID: covidwho-2025727

RESUMO

INTRODUCTION: COVID-19 is a highly contagious disease that was caused by the coronavirus family SARS-CoV-2 and which emerged in China in 2019. This study aimed to investigate the effect of chronic disease mortality on the COVID-19 fatality rate. METHODS: In our study, a total of 44 countries including 37 OECD countries were evaluated. A model was created with variables including death percentages of cardiovascular disease (CVD), cancer, chronic respiratory system diseases, diabetes and also age, gross domestic product (GDP), and the number of beds and the effect on COVID-19 fatality rate were evaluated. Multiple regression analysis was used to evaluate the model created. RESULTS: It was determined that the average age and diabetes deaths among the non-communicable disease deaths positively predicted the COVID-19 fatality rate. In the model created in the study, the effect of the number of patient beds, GDP, and deaths due to CVD, cancer, and chronic respiratory diseases on the COVID-19 fatality rate was not determined. DISCUSSION AND CONCLUSION: In the study, older age and diabetes deaths positively predicted the COVID-19 fatality rate. In regions with high average age and diabetes mortality, additional policies may be required to reduce the COVID-19 fatality rate.

7.
Journal of Advanced Biotechnology and Experimental Therapeutics ; 5(3):445-455, 2022.
Artigo em Inglês | Scopus | ID: covidwho-2025149

RESUMO

Compared to other pandemic diseases, COVID-19 had the highest transmission rate and high fatality risk. Diabetes is the hand was also one of the most frequent diseases among individuals. This study aimed to evaluate the relationship between diabetic patients infected by COVID-19 and some hematological parameters associated with diabetes and COVID-19.ICLE Patients with COVID-19 were diagnosed by PCR and/or chest computer topography (CT) scan, eight parameters were detected by AFIAS-6. The results of eight parameters for patients with diabetes mellitus infected with COVID-19 and patients with COVID-19 only showed that the Mean of Fasting Blood Glucose (FBG), glycated haemoglobin HbA1c, Insulin Sensitivity (INS) and ferritin show significant differences at (0.000, 0.000, 0.017, 0.000) respectively for the two groups, while insulin resistance (INR), insulin (IN), C-reactive protein (CRP) and D-dimer don’t show any significant differences for two groups, the statistical analysis performed at P-value ≤ 0.01 and 0.05. Infection duration results showed that the mean Insulin level (IN) and D-dimer show significant differences at (0.033 and 0.011) respectively for all infection duration categories, while FBG, HbA1c, INR, INS, CRP, and ferritin don’t show any significant differences for all day’s category. The Correlation Coefficients Between diabetes mellitus patients infected with COVID-19 and blood parameters highly correlated between FBG with INR at (0.647), HbA1c with IN at (0.078), INR with IN at (0.791), INS with CT-Scan at (0.058), CRP with D-dimer at (0.287), D-dimer with ferritin at (0.331), Ferritin with infection duration at (0.098). In conclusion, we find that the diabetes mellitus patients infected with COVID-19 suffer from a high increase of inflammatory proteins and parameters associated with diabetes compared to other patients infected with COVID-19 only, making them more susceptible to disease and more deaths compared to other people. © 2022, Bangladesh Society for Microbiology, Immunology and Advanced Biotechnology. All rights reserved.

8.
Asian Pacific Journal of Tropical Medicine ; 15(7):287-289, 2022.
Artigo em Inglês | Scopus | ID: covidwho-2024694
9.
Molecules ; 27(16):5292, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023937

RESUMO

The G-protein-coupled bile acid receptor, Gpbar1 or TGR5, is characterized as a membrane receptor specifically activated by bile acids. A series of evidence shows that TGR5 induces protein kinase B (AKT), nuclear factor kappa-B (NF-κB), extracellular regulated protein kinases (ERK1/2), signal transducer and activator of transcription 3 (STAT3), cyclic adenosine monophosphate (cAMP), Ras homolog family member A (RhoA), exchange protein activated by cAMP (Epac), and transient receptor potential ankyrin subtype 1 protein (TRPA1) signaling pathways, thereby regulating proliferation, inflammation, adhesion, migration, insulin release, muscle relaxation, and cancer development. TGR5 is widely distributed in the brain, lung, heart, liver, spleen, pancreas, kidney, stomach, jejunum, ileum, colon, brown adipose tissue (BAT), white adipose tissue (WAT), and skeletal muscle. Several recent studies have demonstrated that TGR5 exerts inconsistent effects in different cancer cells upon activating via TGR5 agonists, such as INT-777, ursodeoxycholic acid (UDCA), and taurolithocholic acid (TLCA). In this review, we discuss both the ‘friend’ and ‘foe’ features of TGR5 by summarizing its tumor-suppressing and oncogenic functions and mechanisms.

10.
Metabolites ; 12(8):712, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023907

RESUMO

In addition to metabolic disorders, which include impaired glucose tolerance, abdominal obesity, decreased high-density lipoprotein cholesterol (HDL-C) level and elevated triglycerides (TG), metabolic syndrome is characterized by a procoagulant, proinflammatory and prooxidant state [2], which further increases the likelihood of developing ischemic cardiovascular (CVD) and cerebrovascular diseases. [...]it was documented that moderate hyperglycemia per se is associated with increased risk of pregnancy complications [5]. [...]a mounting body of evidence point towards increased risk for cardiometabolic disorders of both mother and a child in the future [6]. [...]the implementation of metabolomics biomarkers in clinical practice is faced with several limitations, the most important being restricted availability to the clinicians, unmet need for validation and harmonization of the assays and uncertain cost-effectiveness, which require further evaluation. Data from large epidemiological studies and clinical trials have provided significant evidence that lowering fasting and post-prandial glycemia, as well as ameliorating other indices of glucose metabolism alterations, such as glycated hemoglobin (HbA1c), is an effective approach to reduce cardiometabolic risk [21].

11.
Life ; 12(8):1217, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023873

RESUMO

Simple SummaryPositron emission tomography/computed tomography (PET/CT) imaging with 2-deoxy-2-[18F]fluoro-d-glucose (2-[18F]FDG) could be a useful diagnostic tool to detect foci of infection or inflammation in patients with fever of unknown origin (FUO) or with inflammation of unknown origin (IUO). We report a case of a patient originally presenting with a clinical history of FUO and later with persistent high-sensitivity C-reactive protein (hsCRP) levels, even after antibiotic therapy. The patient underwent 2-[18F]FDG PET/CT to investigate and to localize a possible focus of infection or inflammation. Since only 2-[18F]FDG hotspots were detected in both thyroid lobes, specific thyroid diagnostic examinations were performed. Subacute thyroiditis (SAT) was then diagnosed, and other possible causes of FUO or IUO were excluded. We found it interesting to present this case to illustrate the potential diagnostic value of 2-[18F]FDG PET/CT imaging in patients with atypical SAT presenting only with FUO.Background: Positron emission tomography/computed tomography (PET/CT) imaging with 2-deoxy-2-[18F]fluoro-d-glucose (2-[18F]FDG) is a sensitive diagnostic imaging modality in oncology and could be a useful diagnostic tool in patients with fever of unknown origin (FUO) or with inflammation of unknown origin (IUO). Case presentation: We report a case of a patient originally presenting with a clinical history of FUO and later with persistent high-sensitivity C-reactive protein (hsCRP) levels, even after antibiotic therapy. The patient underwent 2-[18F]FDG PET/CT to investigate and to localize a possible focus of infection or inflammation. 2-[18F]FDG hotspots were detected in both thyroid lobes. Thyroid diagnostic examinations and follow up were performed. Subacute thyroiditis (SAT) was then diagnosed by thyroid examinations, and other possible causes of FUO or IUO were not found. Conclusion: This case illustrates the potential diagnostic value of 2-[18F]FDG PET/CT in patients with atypical SAT, who originally present with only a clinical history of FUO.

12.
Journal of Personalized Medicine ; 12(8):1233, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023822

RESUMO

Precision prevention for T1D considers the individual’s unique T1D risk profile (genetic susceptibility given from human leukocyte antigen HLA and non-HLA loci) to predict the individual response to the preventive agents (immune therapy or dietary intervention);however, we need to learn more about the role of environment in the onset of T1D, considering urban versus rural setting, the contribution of virus as SARS-COV2, life stressors or traumatic events, and food [6,7,8]. Precision prevention for T2D does not consider intervening in everyone with prediabetes, because it is not cost-effective [17], but on a subset of prediabetic patients chosen on the basis of other relevant risk factors (lifestyle, socioeconomic status, family history of diabetes, ethnicity, overweight–obesity, signs of insulin resistance, genetics). Unfortunately most cases of monogenic diabetes remain misdiagnosed, mainly due to the cost of performing genetic testing [3];other limits in implementing precision medicine in diabetes include epidemiological differences among varied populations (ethnic and racial barriers) and that some ethnic groups are underrepresented in clinical trials [20]. [...]the application of precision medicine in diagnosis and in treatment of monogenic diabetes is a standard of care [3].

13.
International Journal of Molecular Sciences ; 23(17):9957, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023753

RESUMO

Globally, better health care access and social conditions ensured a significant increase in the life expectancy of the population. There is, however, a clear increase in the incidence of age-related diseases which, besides affecting the social and economic sustainability of countries and regions around the globe, leads to a decrease in the individual’s quality of life. There is an urgent need for interventions that can reverse, or at least prevent and delay, the age-associated pathological deterioration. Within this line, this narrative review aims to assess updated evidence that explores the potential therapeutic targets that can mimic or complement the recognized anti-aging effects of physical exercise. We considered pertinent to review the anti-aging effects of the following drugs and supplements: Rapamycin and Rapamycin analogues (Rapalogs);Metformin;2-deoxy-D-glucose;Somatostatin analogues;Pegvisomant;Trametinib;Spermidine;Fisetin;Quercetin;Navitoclax;TA-65;Resveratrol;Melatonin;Curcumin;Rhodiola rosea and Caffeine. The current scientific evidence on the anti-aging effect of these drugs and supplements is still scarce and no recommendation of their generalized use can be made at this stage. Further studies are warranted to determine which therapies display a geroprotective effect and are capable of emulating the benefits of physical exercise.

14.
International Journal of Environmental Research and Public Health ; 19(16):10339, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2023669

RESUMO

Limited studies have focused on maternal early-life risk factors and the later development of gestational diabetes mellitus (GDM). We aimed to estimate the GDM prevalence and examine the associations of maternal early-life risk factors, namely: maternal birthweight, parental smoking at birth, childhood urbanicity, ever-breastfed, parental education attainment, parental history of diabetes, childhood overall health, childhood body size, and childhood height, with later GDM. This was a retrospective cross-sectional study using the UAE Healthy Future Study (UAEHFS) baseline data (February 2016 to April 2022) on 702 ever-married women aged 18 to 67 years. We fitted a Poisson regression to estimate the risk ratio (RR) for later GDM and its 95% confidence interval (CI). The GDM prevalence was 5.1%. In the fully adjusted model, females with low birthweight were four times more likely (RR 4.04, 95% CI 1.36–12.0) and females with a parental history of diabetes were nearly three times more likely (RR 2.86, 95% CI 1.10–7.43) to report later GDM. In conclusion, maternal birthweight and parental history of diabetes were significantly associated with later GDM. Close glucose monitoring during pregnancy among females with either a low birth weight and/or parental history of diabetes might help to prevent GDM among this high-risk group.

15.
Frontiers in Nutrition ; 9, 2022.
Artigo em Inglês | Web of Science | ID: covidwho-2022810

RESUMO

Metabolic diseases are major public health issues worldwide and are responsible for disproportionately higher healthcare costs and increased complications of many diseases including SARS-CoV-2 infection. The Western Diet (WD) specifically is believed to be a major contributor to the global metabolic disease epidemic. In contrast, the Mediterranean diet (MeD), Ketogenic diet (KD), and Japanese diet (JD) are often considered beneficial for metabolic health. Yet, there is a growing appreciation that the effect of diet on metabolic health varies depending on several factors including host genetics. Additionally, poor metabolic health has also been attributed to altered gut microbial composition and/or function. To understand the complex relationship between host genetics, gut microbiota, and dietary patterns, we treated four widely used metabolically diverse inbred mouse strains (A/J, C57BL/6J, FVB/NJ, and NOD/ShiLtJ) with four human-relevant diets (MeD, JD, KD, WD), and a control mouse chow from 6 weeks to 30 weeks of age. We found that diet-induced alteration of gut microbiota (alpha-diversity, beta-diversity, and abundance of several bacteria including Bifidobacterium, Ruminococcus, Turicibacter, Faecalibaculum, and Akkermansia) is significantly modified by host genetics. In addition, depending on the gut microbiota, the same diet could have different metabolic health effects. Our study also revealed that C57BL/6J mice are more susceptible to altered gut microbiota compared to other strains in this study indicating that host genetics is an important modulator of the diet-microbiota-metabolic health axis. Overall, our study demonstrated complex interactions between host genetics, gut microbiota, and diet on metabolic health;indicating the need to consider both host genetics and the gut microbiota in the development of new and more effective precision nutrition strategies to improve metabolic health.

16.
Diabetes Spectrum ; 35(3):358-366, 2022.
Artigo em Inglês | CINAHL | ID: covidwho-2022462

RESUMO

Objective: Nutrition therapy is a cornerstone of care for people with type 2 diabetes, yet starting new, healthy eating behaviors and sustaining them can be challenging. This decentralized, single-arm study assessed the impact of 28 days of home-delivered, pre-portioned meals (three meals per day) on continuous glucose monitoring (CGM)-derived glycemic control and quality of life. Research design and methods: We enrolled 154 people with type 2 diabetes from across the United States. All participants were enrolled in a digital-first type 2 diabetes care center of excellence and had a time in range (TIR) <70% or a glucose management index (GMI) >7%. A total of 102 participants received another set of meals for a household member. Forty-four participants were excluded from CGM-based analysis because of sparse data in the baseline or intervention period. Results: From the baseline through the intervention period, average TIR improved by 6.8% (95% CI 4.0–9.7, P <0.001), average GMI improved by 0.21% (95% CI 0.11–0.32, P <0.001), and participants' odds of achieving ≥70% TIR increased (odds ratio 2.55 [95% CI 0.93–7.80, P = 0.051]). Although average TIR increased rapidly upon initiation of meal delivery, it regressed when the delivery period ended. Conclusion: Home-delivered meals were associated with modest TIR and GMI improvements, but only in the short term. More research is needed to determine whether the effects of nutrition therapy can be extended by providing ongoing meal delivery or additional support such as behavioral intervention.

17.
Journal of Medical Internet Research ; 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2022362

RESUMO

Background: Extensive literature support telehealth as a supplement or adjunct to in-person care for the management of chronic conditions such as congestive heart failure (CHF) and type 2 diabetes mellitus (T2DM). Evidence is needed to support the use of telehealth as an equivalent and equitable replacement for in-person care and to assess potential adverse effects. Objective: We conducted a systematic review to address the following question: among adults, what is the effect of synchronous telehealth (real-time response among individuals via phone or phone and video) compared with in-person care (or compared with phone, if synchronous video care) for chronic management of CHF, chronic obstructive pulmonary disease, and T2DM on key disease-specific clinical outcomes and health care use? Methods: We followed systematic review methodologies and searched two databases (MEDLINE and Embase). We included randomized or quasi-experimental studies that evaluated the effect of synchronously delivered telehealth for relevant chronic conditions that occurred over ≥2 encounters and in which some or all in-person care was supplanted by care delivered via phone or video. We assessed the bias using the Cochrane Effective Practice and Organization of Care risk of bias (ROB) tool and the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation. We described the findings narratively and did not conduct meta-analysis owing to the small number of studies and the conceptual heterogeneity of the identified interventions. Results: We identified 8662 studies, and 129 (1.49%) were reviewed at the full-text stage. In total, 3.9% (5/129) of the articles were retained for data extraction, all of which (5/5, 100%) were randomized controlled trials. The CHF study (1/5, 20%) was found to have high ROB and randomized patients (n=210) to receive quarterly automated asynchronous web-based review and follow-up of telemetry data versus synchronous personal follow-up (in-person vs phone-based) for 1 year. A 3-way comparison across study arms found no significant differences in clinical outcomes. Overall, 80% (4/5) of the studies (n=466) evaluated synchronous care for patients with T2DM (ROB was judged to be low for 2, 50% of studies and high for 2, 50% of studies). In total, 20% (1/5) of the studies were adequately powered to assess the difference in glycosylated hemoglobin level between groups;however, no significant difference was found. Intervention design varied greatly from remote monitoring of blood glucose combined with video versus in-person visits to an endocrinology clinic to a brief, 3-week remote intervention to stabilize uncontrolled diabetes. No articles were identified for chronic obstructive pulmonary disease. Conclusions: This review found few studies with a variety of designs and interventions that used telehealth as a replacement for in-person care. Future research should consider including observational studies and studies on additional highly prevalent chronic diseases.

18.
PLoS One ; 17(8), 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2021905

RESUMO

Background Diabetes Mellitus (DM), a chronic metabolic disorder that caused about 4.2 million deaths and at least 760 billion dollars’ expenditure in 2019, has been targeted for action by leaders of WHO member countries. In Ethiopia deaths, due to DM reached 34,262 in 2013. Studies show effective lifestyle interventions;particularly medical nutrition therapy reduces HbA1c by 0.5 to 2%. However, practicing recommended diet is reported to be difficult. Not only Knowledge and practice but also perception studies are therefore necessary to design future health programs. Objective To assess diabetic self-care, dietary practice and associated factors among diabetes patients. Method Institution-basedbased cross-sectional study design was employed from february15-May15, 2020 in Jimma university medical Centre (JUMC). Systematic sampling of every other patient (K = 2.7) was employed to interview 371 participants. A previously validated tool was used to collect data through a face-to-face interview. A path analysis was used to fit the structural model and tests the hypothesized Health Belief Model (HBM) relationships. Result Response rate was 95.4% (354). Around 52% of the participants were male and 76.8% follow diabetic education at least some times. 42.4% and 48% of respondents have good dietary and general self-care practices respectively. With unstandardized coefficient (standard error) self-efficacy0.10 (0.01) being the strongest cues to action0.10 (0.02), perceived threat0.02 (0.01), and perceived barrier-0.08(0.01) constructs of HBM have a significant effect on dietary practice. Knowledge, social support and diabetes distress exert a significant indirect effect on dietary practice through health belief constructs with unstandardized path coefficient (standard error) of 0.22(0.03), 0.02(0.01), and -0.03(0.004) respectively. Conclusion In this study, the proportion of good practice is found to be lower for both dietary as well as general self-care. HBM can best fit to explain variability in dietary self-care practice;therefore, future interventions should be designed to address the vast perception and psychosocial factors influencing dietary self-care practices.

19.
Journal of NeuroInterventional Surgery ; 14(Suppl 2):A41-A42, 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2020243

RESUMO

IntroductionHigh blood glucose was shown to be associated with worse clinical outcome and increased edema formation in patient with acute stroke undergoing mechanical thrombectomy.1 A better understanding of the pathophysiological pathways and a quantification of their effects might support targeted therapeutic approaches.Aim of the StudyTo quantify the amount of outcome deterioration explained by edema formation due to high blood glucose.Methods124 patients with acute ischemic stroke who underwent mechanical thrombectomy were included. Mediation analysis was performed to quantify the amount of outcome deterioration (probability for mRS>2) explained by edema formation in patients with high blood glucose. In addition, the moderating effects of good and poor collaterals were investigated.ResultsProbability for poor outcome increased with increasing blood glucose levels (OR 1.23/10 mg/dl), edema formation (OR 1.13/% net water uptake) and poor collaterals (OR 1.64). Edema formation was also associated with higher blood glucose levels (regression coefficient 0.033). An increase of blood glucose levels from 100mg/dl to 200mg/dl resulted in a 47 percentage-points decrease of the probability of good outcome in patients with good collaterals and a 26 percentage points decrease in patients with poor collaterals. Edema formation explained 15% of the outcome deterioration caused by higher blood glucose levels.ConclusionEdema formation explains 15% of the total adverse effects of high blood glucose levels. Major pathways might include other direct effects of high blood glucose, such as altered vessel wall and thrombus characteristics and higher thrombogenicity of the cerebral blood flow.ReferencesThorén, M., et al. “Predictors for Cerebral Edema in Acute Ischemic Stroke Treated with Intravenous Thrombolysis.” Stroke 2017;48(9): 2464–2471.Do you have any conflict of interest to declare?: YesHelge Kniep is a consultant for Eppdata.Jens Fiehler received research support from: German Ministry of Science and Education (BMBF), German Ministry of Economy and Innovation (BMWi), German Research Foundation (DFG), European Union (EU), Hamburgische Investitions- und Förderbank (IFB), Medtronic, Microvention, Route92, Stryker. He is consultant for: Acandis, Bayer, Cerenovus, Covidien, Medtronic, Microvention, Penumbra, Phenox, Stryker and stock holder of Tegus Medical.

20.
BMJ Paediatrics Open ; 6(1), 2022.
Artigo em Inglês | ProQuest Central | ID: covidwho-2020092

RESUMO

ObjectiveTo determine the extent to which the presence of acanthosis nigricans confers additional risk for insulin resistance, in addition to obesity alone (body mass index, BMI) within a young, overweight, UK population.Research design and methodsRetrospective data were collected to compare the degree of insulin resistance within a sample of 94 young people with acanthosis nigricans, and a matched cohort of 94 participants with obesity alone. Insulin resistance was assessed by fasting glucose, fasting insulin and Homeostatic Model Assessment of insulin resistance (HOMA-IR) score (a mathematical model derived to measure insulin resistance).ResultsThe acanthotic and control group were well matched for age, BMI, BMI SDS and sex, although the groups were not matched for ethnicity. The acanthotic group showed a significantly greater median fasting insulin (215 pmol/L), mean fasting glucose (4.7 mmol/L) and median HOMA-IR score (6.4), compared with the control group (126 pmol/L, 4.5 mmol/L and 3.7, respectively). The presence of acanthosis nigricans as an indicator of insulin resistance was found to have a positive predictive value of 81% (within this study population).ConclusionIndividuals with both acanthosis nigricans and obesity had significantly greater degrees of insulin resistance than individuals with obesity alone. The findings support the potential for acanthosis nigricans as a visible marker of type 2 diabetes in young people.

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