Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 49.368
Filtrar
1.
J Nutr Health Aging ; 24(6): 560-562, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32510106

RESUMO

OBJECTIVE: No studies analyzing the role of dementia as a risk factor for mortality in patients affected by COVID-19. We assessed the prevalence, clinical presentation and outcomes of dementia among subjects hospitalized for COVID19 infection. DESIGN: Retrospective study. SETTING: COVID wards in Acute Hospital in Brescia province, Northern Italy. PARTICIPANTS: We used data from 627 subjects admitted to Acute Medical wards with COVID 19 pneumonia. MEASUREMENTS: Clinical records of each patients admitted to the hospital with a diagnosis of COVID19 infection were retrospectively analyzed. Diagnosis of dementia, modalities of onset of the COVID-19 infection, symptoms of presentation at the hospital and outcomes were recorded. RESULTS: Dementia was diagnosed in 82 patients (13.1%). The mortality rate was 62.2% (51/82) among patients affected by dementia compared to 26.2% (143/545) in subjects without dementia (p<0.001, Chi-Squared test). In a logistic regression model age, and the diagnosis of dementia resulted independently associated with a higher mortality, and patients diagnosed with dementia presented an OR of 1.84 (95% CI: 1.09-3.13, p<0.05). Among patients diagnosed with dementia the most frequent symptoms of onset were delirium, especially in the hypoactive form, and worsening of the functional status. CONCLUSION: The diagnosis of dementia, especially in the most advanced stages, represents an important risk factor for mortality in COVID-19 patients. The clinical presentation of COVID-19 in subjects with dementia is atypical, reducing early recognition of symptoms and hospitalization.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Demência/complicações , Pneumonia Viral/complicações , Idoso , Idoso de 80 Anos ou mais , Demência/epidemiologia , Feminino , Humanos , Itália/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Pandemias , Prevalência , Estudos Retrospectivos , Fatores de Risco
2.
Epidemiol Health ; 42: e2020031, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32493005

RESUMO

OBJECTIVES: The characteristics of depressive symptoms in the family members of home-dwelling patients with dementia have not been clearly reported. This study aimed to investigate the characteristics of depressive symptoms in middle-aged family members living with a patient with dementia. METHODS: This study used the data from the nationwide 2017 Korea Community Health Survey. Among the 228,381 survey participants, 77,276 participants in their 40s and 50s were finally selected for this study. The participants consisted of 760 family members of home-dwelling dementia patients and 76,516 general family members comprising a control group. RESULTS: The positive rate of Patient Health Questionnaire-9 (PHQ-9)-measured depressive symptoms was significantly higher in the family members of home-dwelling dementia patients (4.4%; control group: 1.9%). After adjusting for potential confounders, the prevalence of PHQ-measured depressive symptoms was 1.72 times (95% confidence interval [CI], 1.03 to 2.85) higher in the family members of home-dwelling dementia patients compared to the control group. The positive rate of depressive symptoms was 2.26 times higher (95% CI, 1.26 to 4.05) in the female middle-aged family members of home-dwelling dementia patients compared to the control group. In addition, those who reported having symptoms almost every day in the PHQ-9 questions had significantly higher positive rates on questions about loss of interest, depression, sleep disturbance, fatigue, poor appetite, and suicidal ideation, and not on questions regarding feelings of worthlessness and psychomotor agitation, compared to the control group. CONCLUSIONS: Active interventions are needed to relieve depression in the family members of home-dwelling dementia patients.


Assuntos
Cuidadores/psicologia , Demência/terapia , Depressão/epidemiologia , Adulto , Idoso , Cuidadores/estatística & dados numéricos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Características de Residência
3.
Cien Saude Colet ; 25(suppl 1): 2457-2460, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32520289

RESUMO

Mental disorders (MD) are commonly comorbid with cardiovascular, metabolic, and some infectious diseases. Since the current SARS-CoV-2 epidemic is affecting the most multimorbid individuals, we might expect that the epidemic will be particularly problematic for people with MD. Understanding the burden of an outbreak on mental health is fundamental to effective action towards containing the spread of the disease, as psychopathology might reduce endurance during the lockdown. This can potentially reduce adhesion to ongoing treatment resulting in avoidable recurrence of a disorder. Additionally, there is the stress caused by the eminent risk of infection or economic uncertainty, especially in low-middle income settings. This is an overview on the expected influence of the COVID-19 on mental health from a research group that has not long ago been involved in the Zika epidemic. It aims to discuss the effects of the pandemic on a Low and Middle-Income country (LMIC), Brazil.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Países em Desenvolvimento , Saúde Mental , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Transtorno Bipolar/psicologia , Transtorno Bipolar/terapia , Brasil , Cuidadores , Demência/enfermagem , Família , Acesso aos Serviços de Saúde , Humanos , Transtornos Mentais/tratamento farmacológico , Transtornos Mentais/epidemiologia , Transtornos Mentais/psicologia , Multimorbidade , Sensação , Isolamento Social
5.
Medicine (Baltimore) ; 99(21): e20225, 2020 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-32481294

RESUMO

We examined the process of obtaining informed consent (IC) for clinical research purposes in long-term care facilities (LTCFs) in Rhode Island (RI), USA. We assessed factors that were associated with resident ability to consent, such as Brief Interview for Mental Status scores. We used a self-administered questionnaire to further understand the effect of LTCF staff evaluation of ability to consent on residents' autonomy and control over their medical decision making.Observational clinical studyLong-term care setting.LTCF personnel provided us with residents' names, as well as their professional assessment of resident ability to consent. We used Brief Interview for Mental Status (BIMS) scores to assess the cognitive capacity of all residents to assess, and compare it to the assessment provided by LTCF personnel. A logistic regression analysis was performed to determine the relationship between LTCF assessment of resident ability to consent and BIMS score or confirmed diagnosis of dementia as seen from residents' medical charts. A self-administered questionnaire was filled out by the personnel of 10 LTCFs across RI, USA.LTCF personnel in 9 out of 10 recruited facilities reported that their assessment of resident ability to consent was based on subjective assessment of the resident as alert and oriented. There was a statistically significant relationship between the LTCF assessment of resident ability to consent and previously diagnosed dementia (OR: 0.211, 95% CI 0.107-0.415). Therefore, as BIMS scores increased, the likelihood that the resident would be deemed able to consent by LTCF personnel also increased. Furthermore, there was a statistically significant relationship between LTCF assessment of resident ability to consent and BIMS scores (OR: 1.430, 95% CI 1.274-1.605).There is no standard on obtaining IC for research studies conducted in LTCFs. We recommend that standardizing the process of obtaining IC in LTCFs can enhance the ability to perform research with LTCF residents.


Assuntos
Protocolos Clínicos/normas , Demência/diagnóstico , Consentimento Livre e Esclarecido/normas , Assistência de Longa Duração/ética , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica/métodos , Demência/psicologia , Feminino , Humanos , Assistência de Longa Duração/psicologia , Assistência de Longa Duração/estatística & dados numéricos , Masculino , Testes de Estado Mental e Demência/normas , Pessoa de Meia-Idade , Rhode Island/epidemiologia , Inquéritos e Questionários
6.
JAMA ; 323(19): 1934-1944, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32427305

RESUMO

Importance: The benefit of blood pressure lowering for the prevention of dementia or cognitive impairment is unclear. Objective: To determine the association of blood pressure lowering with dementia or cognitive impairment. Data Sources and Study Selection: Search of PubMed, EMBASE, and CENTRAL for randomized clinical trials published from database inception through December 31, 2019, that evaluated the association of blood pressure lowering on cognitive outcomes. The control groups consisted of either placebo, alternative antihypertensive agents, or higher blood pressure targets. Data Extraction and Synthesis: Data were screened and extracted independently by 2 authors. Random-effects meta-analysis models were used to report pooled treatment effects and CIs. Main Outcomes and Measures: The primary outcome was dementia or cognitive impairment. The secondary outcomes were cognitive decline and changes in cognitive test scores. Results: Fourteen randomized clinical trials were eligible for inclusion (96 158 participants), of which 12 reported the incidence of dementia (or composite of dementia and cognitive impairment [3 trials]) on follow-up and were included in the primary meta-analysis, 8 reported cognitive decline, and 8 reported changes in cognitive test scores. The mean (SD) age of trial participants was 69 (5.4) years and 40 617 (42.2%) were women. The mean systolic baseline blood pressure was 154 (14.9) mm Hg and the mean diastolic blood pressure was 83.3 (9.9) mm Hg. The mean duration of follow-up was 49.2 months. Blood pressure lowering with antihypertensive agents compared with control was significantly associated with a reduced risk of dementia or cognitive impairment (12 trials; 92 135 participants) (7.0% vs 7.5% of patients over a mean trial follow-up of 4.1 years; odds ratio [OR], 0.93 [95% CI, 0.88-0.98]; absolute risk reduction, 0.39% [95% CI, 0.09%-0.68%]; I2 = 0.0%) and cognitive decline (8 trials) (20.2% vs 21.1% of participants over a mean trial follow-up of 4.1 years; OR, 0.93 [95% CI, 0.88-0.99]; absolute risk reduction, 0.71% [95% CI, 0.19%-1.2%]; I2 = 36.1%). Blood pressure lowering was not significantly associated with a change in cognitive test scores. Conclusions and Relevance: In this meta-analysis of randomized clinical trials, blood pressure lowering with antihypertensive agents compared with control was significantly associated with a lower risk of incident dementia or cognitive impairment.


Assuntos
Anti-Hipertensivos/uso terapêutico , Disfunção Cognitiva/prevenção & controle , Demência/prevenção & controle , Hipertensão/tratamento farmacológico , Idoso , Pressão Sanguínea/efeitos dos fármacos , Disfunção Cognitiva/epidemiologia , Demência/epidemiologia , Feminino , Seguimentos , Humanos , Hipertensão/complicações , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Risco
7.
J Med Internet Res ; 22(5): e19434, 2020 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-32401215

RESUMO

BACKGROUND: The public health emergency of coronavirus disease (COVID-19) is rapidly evolving worldwide; some countries, including Spain, have implemented restrictive measures. Populations that are vulnerable to this outbreak and its physical and mental health effects include community-dwelling older adults with mild cognitive impairment or mild dementia. Telehealth is a potential tool to deliver health care and decrease exposure risk. OBJECTIVE: The aims of this study were to explore the impact of confinement on the health and well-being of community-dwelling older adults with mild cognitive impairment or mild dementia, to provide television-based and telephone-based health and social support, and to study the effects of a television-based assistive integrated technology, TV-AssistDem (TeleVision-based ASSistive Integrated Service to supporT European adults living with mild DEMentia or mild cognitive impairment). METHODS: A telephone-based survey was administered in Spain to 93 participants in the TV-AssistDem clinical trial from March 25 to April 6, 2020. RESULTS: Of the respondents, 60/93 (65%) were women. The mean age was 73.34 (SD 6.07), and 69/93 (74%) lived accompanied. Lockdown measures forced 17/93 respondents (18%) to change their living arrangements. Health status was found to be optimal in 89/93 respondents (96%), with no COVID-19 symptoms. Grocery and pharmacy outings were performed by family members of 68/93 participants (73%); 57 (61%) reported overall well-being, and 65 (70%) maintained their sleep quality. However, participants living alone reported greater negative feelings and more sleeping problems. Regarding leisure activities, 53/93 respondents (57%) took walks, 32 (35%) played memory games, 55 (60%) watched television, and 91 (98%) telephoned relatives. 58/93 (64%) respondents reported accessing moderate or too much COVID-19 information, 89 (97%) received it from television, and 56 (62%) stated that their understanding of the information was extreme. 39/93 (39%) respondents had contacted health and social services, while 29 (31%) requested information regarding these services during the telephone call. There were no significant differences in health and well-being between the intervention and control groups. Respondents with TV-AssistDem performed more memory exercises (24/93, 52% vs 8/93, 17.4%; P<.001) than control respondents. CONCLUSIONS: Our findings suggest that during COVID-19 confinement, the physical and mental health and well-being was optimal for the majority of our vulnerable population. However, those living alone reported greater negative psychological effects and sleeping problems. Measures adopted to address the negative experiences of confinement included keeping informed about the situation, accessing health and social services, having a support network that prevents risk of exposure to COVID-19 and guarantees food and medical supplies, a daily routine with maintained sleeping habits and leisure activities, staying physically and mentally active with cognitive stimulation exercises, and ensuring social connectedness using technology. Television sets were preferred technological devices to access COVID-19 information, watch television as a recreational activity, and perform memory exercises as an intellectual activity. Television-based telehealth support using TV-AssistDem demonstrated potential for cognitive stimulation. TRIAL REGISTRATION: ClinicalTrials.gov NCT03653234; https://clinicaltrials.gov/ct2/show/NCT03653234.


Assuntos
Disfunção Cognitiva/terapia , Infecções por Coronavirus/epidemiologia , Demência/terapia , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Idoso , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Quarentena , Apoio Social , Inquéritos e Questionários
8.
Z Gerontol Geriatr ; 53(4): 340-346, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32430766

RESUMO

Geriatric medicine is a rapidly evolving field that addresses diagnostic, therapeutic and care aspects of older adults. Some disabilities and disorders affecting cognition (e.g. dementia), motor function (e.g. stroke, Parkinson's disease, neuropathies), mood (e.g. depression), behavior (e.g. delirium) and chronic pain disorders are particularly frequent in old subjects. As knowledge about these age-associated conditions and disabilities is steadily increasing, the integral implementation of neurogeriatric knowledge in geriatric medicine and specific neurogeriatric research is essential to develop the field. This article discusses how neurological know-how could be integrated in academic geriatric medicine to improve care of neurogeriatric patients, to foster neurogeriatric research and training concepts and to provide innovative care concepts for geriatric patients with predominant neurological conditions and disabilities.


Assuntos
Demência/terapia , Geriatria , Doenças do Sistema Nervoso/terapia , Doença de Parkinson/terapia , Idoso , Delírio , Humanos
10.
Adv Exp Med Biol ; 1233: 177-194, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32274757

RESUMO

Tauopathies are a heterogeneous group of neurodegenerative dementias involving perturbations in the levels, phosphorylation or mutations of the neuronal microtubule-binding protein Tau. Tauopathies are characterized by accumulation of hyperphosphorylated Tau leading to formation of a range of aggregates including macromolecular ensembles such as Paired Helical filaments and Neurofibrilary Tangles whose morphology characterizes and differentiates these disease states. Why nonphysiological Tau proteins elude the surveillance normal proteostatic mechanisms and eventually form these macromolecular assemblies is a central mostly unresolved question of cardinal importance for diagnoses and potential therapeutic interventions. We discuss the response of the Ubiquitin-Proteasome system, autophagy and the Endoplasmic Reticulum-Unfolded Protein response in Tauopathy models and patients, revealing interactions of components of these systems with Tau, but also of the effects of pathological Tau on these systems which eventually lead to Tau aggregation and accumulation. These interactions point to potential disease biomarkers and future potential therapeutic targets.


Assuntos
Proteostase , Tauopatias/metabolismo , Tauopatias/patologia , Demência/genética , Demência/metabolismo , Demência/patologia , Humanos , Emaranhados Neurofibrilares/genética , Emaranhados Neurofibrilares/metabolismo , Emaranhados Neurofibrilares/patologia , Fosforilação , Complexo de Endopeptidases do Proteassoma/metabolismo , Tauopatias/genética , Ubiquitina/metabolismo , Proteínas tau/química , Proteínas tau/genética , Proteínas tau/metabolismo
11.
Am Surg ; 86(3): 208-212, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-32223799

RESUMO

Gun-related injuries are a hotly debated sociopolitical topic in the United States. Annually, more than 33 million Americans seek heathcare services for mental health issues. These conditions are the leading cause of combined disability and death among women and the second highest among men. Our study's main objective was to identify cases of self-inflicted penetrating firearm injuries with reported pre-existing psychiatric conditions as defined in the 2013-2016 National Trauma Data Standard. The 2013-2016 Research Data Sets (RDSs) were reviewed. Cases were identified using the ICD-9 external cause codes 955-955.4, and ICD 10th Edition Clinical Modification external cause codes X72-X74. Odds ratios were calculated, and categorical data were analyzed by using the chi-squared test, with significance defined as P < 0.05. The 2013-2016 Research Data Set consists of 3,577,168 reported cases, with 15,535 observations of self-inflicted penetrating firearms injuries. Of those patients, 18.4 per cent had major psychiatric illnesses, 7.5 per cent had alcohol use disorder, 6.4 per cent had drug use disorder, and 0.6 per cent had dementia. An upward trend in the proportion of patients with major psychiatric illnesses was observed, from 15.5 per cent in 2013 to 18.6 per cent in 2016, peaking in 2015 at 20.9 per cent. Nearly one in three self-inflicted penetrating firearm injuries in the United States is associated with pre-existing behavioral health conditions. Advances in understanding the behavioral and social determinants leading to these conditions, and strategies to improve the diagnosis of mental illness and access to mental health care are required.


Assuntos
Violência com Arma de Fogo/psicologia , Violência com Arma de Fogo/estatística & dados numéricos , Cobertura de Condição Pré-Existente/estatística & dados numéricos , Comportamento Autodestrutivo/epidemiologia , Ferimentos por Arma de Fogo/epidemiologia , Adulto , Idoso , Alcoolismo/epidemiologia , Bases de Dados Factuais , Demência/epidemiologia , Feminino , Armas de Fogo , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estados Unidos/epidemiologia
13.
Hu Li Za Zhi ; 67(1): 75-83, 2020 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-32281085

RESUMO

BACKGROUND: Face (self-esteem) is an issue that involves socially endowed status, identity roles, and self-image management and maintenance. People with dementia and their family members often experience social isolation due to diminished self-image, which affects disease progression. Better understanding the factors that influence the self-image of people with dementia may promote the ability of caregivers to maintain self-image and promote public understanding and empathy toward people with dementia. PURPOSE: The aim of this study was to explore the factors influencing self-image in people with dementia using a systematic review of the literature. METHODS: A systematic review was used. Articles were retrieved from electronic databases including PubMed, CINAHL, Airiti Library, and Cochrane Library. The following keywords and MeSH terms were used to search for articles on dementia, face, self-esteem, respect, and self-concept. A total of 3,050 articles published prior to September 2018 that matched the search criteria were extracted. After screening the topics, deleting repetitions, and doing critical appraisals, eight articles were selected for analysis. Research quality was appraised using the Joanna Briggs Institute and the Melnyk and Fineout-Overholt for Evidence-Based Medicine Level of Evidence. RESULTS: Two themes related to the factors influencing self-image in people with dementia were extracted from the selected articles. The first theme was "loss of self-identity". As people with dementia gradually lose their cognitive function and memory ability, they are increasingly incapable of handling and managing their current role tasks. The second theme was "negative public perception". The public believes that people with dementia are at risk to others and that their behaviors are unpredictable, resulting in the deprivation of the rights to which people with dementia are entitled. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Because of disease progression, people with dementia gradually lose their self-identity and become unable to perform their life-role tasks. This is accompanied by negative perceptions of the disease among the public, which, in turn, damages the self-image of people with dementia and their families. The results of this review may provide a reference for caregivers planning future person-centered care approaches for people with dementia. In addition, these results may help facilitate the establishment of a more friendly environment for people with dementia in both public and private spaces.


Assuntos
Demência/psicologia , Autoimagem , Cuidadores/psicologia , Demência/terapia , Empatia , Humanos
14.
Orv Hetil ; 161(18): 727-737, 2020 05 01.
Artigo em Húngaro | MEDLINE | ID: mdl-32338488

RESUMO

Dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD) are two major neurodegenerative diseases sharing common clinical, pathophysiological and morphologic features. The pathological hallmark of both diseases is the presence of Lewy-bodies (LB). The main constituent of these inclusions is the pathologically aggregated α-synuclein protein. In DLB, LBs are predominantly located in the cortex, whereas in PDD, the subcortical regions are predominantly affected. Furthermore, in DLB, coexisting Alzheimer's disease (AD), pathology with ß-amyloid plaques and neurofibrillary tangles are more common. It is still debated whether DLB and PDD are two distinct entities or different phenotypes of the same disease. Clinical diagnosis is based on the temporal sequence of motor and cognitive symptoms. Dementia often precedes parkinsonism in DLB, while in PDD, cognitive decline generally appears after the onset of motor symptoms. Also, fluctuation of cognitive functions and neuroleptic sensitivity is more severe in DLB than PDD. The recent advancements of imaging techniques revealed that cortical damage, cholinergic deficit and concomitant AD pathology are more severe in DLB compared to PDD. The analysis of cerebrospinal fluid biomarkers shows higher oligomeric α-synuclein burden in PDD. Levodopa is less effective in DLB than in PDD and may increase the risk of psychosis. In this review, we comprehensively analyse the pathological, radiological and clinical features of DLB and PDD, highlighting the overlaps and differences. Orv Hetil. 2020; 161(18): 727-737.


Assuntos
Demência/patologia , Doença por Corpos de Lewy/patologia , Doença de Parkinson/patologia , Humanos
18.
Med Clin North Am ; 104(3): 391-403, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312405

RESUMO

Prognostication is a vital aspect of decision making because it provides patients and families with information to establish realistic and achievable goals of care, is used in determining eligibility for certain benefits, and helps in targeting interventions to those likely to benefit. Prognostication consists of 3 components: clinicians use their clinical judgment or other tools to estimate the probability of an individual developing a particular outcome over a specific period of time; this prognostic estimate is communicated in accordance with the patient's information preferences; the prognostic estimate is interpreted by the patient or surrogate and used in clinical decision making.


Assuntos
Competência Clínica/normas , Estado Terminal/terapia , Planejamento de Assistência ao Paciente/normas , Assistência Centrada no Paciente/métodos , Idoso , Idoso de 80 Anos ou mais , Tomada de Decisão Clínica/ética , Comunicação , Estado Terminal/epidemiologia , Demência/mortalidade , Demência/terapia , Feminino , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca/terapia , Humanos , Expectativa de Vida/tendências , Masculino , Neoplasias/mortalidade , Neoplasias/terapia , Cuidados Paliativos/normas , Percepção , Prognóstico , Assistência Terminal/normas
19.
Med Clin North Am ; 104(3): 471-489, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32312410

RESUMO

The purpose of this article is to present evidence on the efficacy and safety of medical cannabis as a therapy for symptom management in palliative care. This article provides an overview of the evidence on the risks and benefits of using medical cannabis for the indications of chronic pain, cancer-related pain, cancer cachexia, dementia, and Alzheimer's disease. Currently, there is insufficient evidence to determine the effectiveness and safety of cannabinoids for most reviewed indications, with the exception of chronic pain. Future research is required before palliative care clinicians can make evidence-based decisions on the integration of medical cannabis as adjunct therapies.


Assuntos
Canabinoides/uso terapêutico , Dor Crônica/tratamento farmacológico , Maconha Medicinal/uso terapêutico , Manejo da Dor/métodos , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/tratamento farmacológico , Caquexia/tratamento farmacológico , Dor do Câncer/tratamento farmacológico , Canabinoides/efeitos adversos , Demência/tratamento farmacológico , Humanos , Maconha Medicinal/efeitos adversos , Metanálise como Assunto , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Manejo da Dor/tendências , Cuidados Paliativos/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Brain Behav Immun ; 87: 53-54, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32311498

RESUMO

While all groups are affected by the COVID-19 pandemic, the elderly, underrepresented minorities, and those with underlying medical conditions are at the greatest risk. The high rate of consumption of diets high in saturated fats, sugars, and refined carbohydrates (collectively called Western diet, WD) worldwide, contribute to the prevalence of obesity and type 2 diabetes, and could place these populations at an increased risk for severe COVID-19 pathology and mortality. WD consumption activates the innate immune system and impairs adaptive immunity, leading to chronic inflammation and impaired host defense against viruses. Furthermore, peripheral inflammation caused by COVID-19 may have long-term consequences in those that recover, leading to chronic medical conditions such as dementia and neurodegenerative disease, likely through neuroinflammatory mechanisms that can be compounded by an unhealthy diet. Thus, now more than ever, wider access to healthy foods should be a top priority and individuals should be mindful of healthy eating habits to reduce susceptibility to and long-term complications from COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Dieta Ocidental/estatística & dados numéricos , Inflamação/epidemiologia , Obesidade/epidemiologia , Pneumonia Viral/epidemiologia , Imunidade Adaptativa/imunologia , Betacoronavirus , Infecções por Coronavirus/imunologia , Demência/epidemiologia , Demência/imunologia , Diabetes Mellitus Tipo 2/imunologia , Dieta , Suscetibilidade a Doenças , Humanos , Imunidade Inata/imunologia , Inflamação/imunologia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/imunologia , Estado Nutricional , Obesidade/imunologia , Pandemias , Pneumonia Viral/imunologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA