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1.
J Affect Disord ; 300: 195-202, 2022 Jan 01.
Article in English | MEDLINE | ID: mdl-34979180

ABSTRACT

BACKGROUND: Several prospective studies have identified that hypertension is an important risk factor of post-stroke depression (PSD). However, the effect of immediate antihypertensive treatment on the risk of PSD in patients with acute ischemic stroke remains unknown. METHODS: In this prespecified depression substudy of the China Antihypertensive Trial in Acute Ischemic Stroke (CATIS) randomized clinical trial, a total of 642 patients with acute ischemic stroke within 48 h of onset and elevated systolic BP at 7 sites of CATIS were included. Patients were randomly assigned to receive antihypertensive treatment (n = 318) or to control group (n = 324). The primary outcome was depression (Hamilton Rating Scale for Depression score≥8) at 3-month posttreatment follow-up. RESULTS: At 24 h after randomization, the mean systolic BP was reduced by 21.6 mm Hg (12.5%) in the treatment group and 13.9 mm Hg (7.9%) in the control group (difference, -7.7 mm Hg [95% CI, -10.2 to -5.2]; P<0.001). The mean systolic BP levels at 7 days (P<0.001) and 14 days (P<0.001) after randomization in treatment group were also significantly lower than those in control group. At 3-month posttreatment follow-up, 122 patients (38.4%) in antihypertensive treatment group and 131 patients (40.4%) in control group developed PSD (odds ratio, 0.92 [95% CI, 0.67 to 1.26]; P = 0.59). LIMITATIONS: All patients in the CATIS trial were Chinese, which might limit the generalizability of our findings to other populations. CONCLUSIONS: Early antihypertensive treatment had no effect on the risk of PSD at 3 months among patients with acute ischemic stroke and elevated BP.

2.
Article in English | MEDLINE | ID: mdl-34978702

ABSTRACT

INTRODUCTION: Coronavirus 2 disease is associated with increased mortality and morbidity in chronic hemodialysis patients METHODS: A retrospective, observational case-control pilot study was conducted on consecutive hemodialysis outpatients (cases) and control group of individuals with preserved renal function. Complete SARS-CoV-2 vaccination with BNT162b2 mRNA vaccine, followed by determination of serum antibodies after the second dose, were required from participants in both groups. Previous COVID-19 was an exclusion criterium. RESULTS: 21 hemodialysis patients (M:F = 13:8, mean age 67.5 ± 13.4) and 16 controls without chronic kidney disease (M:F = 4:12, mean age 46.8 ± 12.7) were included. Hemodialysis patients had lower mean titers of serum antibodies to the SARS-CoV-2 spike antigen compared with controls (492.39 vs 1901.20 IU/mL, respectively; p < 0.001), a finding that was confirmed in the age-matched analysis on 18 participants (580.8 vs 1836.4 IU/mL, p = 0.006). CONCLUSIONS: This study supports the finding of hyporesponsiveness to mRNA vaccination among hemodialysis patients.

3.
BMC Cancer ; 22(1): 21, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980035

ABSTRACT

BACKGROUND: Considering that exposure to sunlight in childhood and adolescence has an important role in skin cancer, so it seems that training protective behaviors in this period is more effective. OBJECTIVES: To survey the application of protection motivation theory (PMT) on skin cancer preventive behaviors among students in rural areas of Fasa city, Iran. METHODS: This study was done in two stages: Phase I of this study, the descriptive-analytic and cross-sectional study was conducted in 2018 to investigate the predictive value of the protection motivation theory on skin cancer preventive behaviors. In the second stage, a quasi-experimental interventional study was conducted on 400 primary school students in 2019. The educational intervention was performed in the experimental group for 8 sessions. Data were collected using a demographic information questionnaire and protection motivation theory before and six months after the intervention. RESULTS: The constructs of protection motivation theory predicted 58.6% of skin cancer preventive behaviors. The results indicated that there was no significant difference between the two groups in terms of knowledge, perceived sensitivity, perceived severity, reward, fear, protection motivation, response efficacy, self-efficacy, response costs, and the skin cancer preventive behaviors in before the intervention (p > 0.05). However, six months after the intervention, the experimental group showed a significant increase in each of the mentioned constructs and skin cancer protective behaviors (p < 0.05). CONCLUSION: This study showed the effectiveness of the intervention based on the PMT constructs in adoption of skin cancer preventive behaviors in 6 months' post intervention in primary school students.

4.
BMC Complement Med Ther ; 22(1): 1, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980092

ABSTRACT

BACKGROUND: This study aimed to evaluate the cost-effectiveness of vitamin D supplementation in preventing type 2 diabetes mellitus (T2DM) among Iranian adolescents. METHODS: This analytical observational study was conducted, using the decision tree model constructed in TreeAge Pro to assess the cost per quality-adjusted life-year (QALY) of monthly intake vitamin D supplements to prevent T2DM compared to no intervention from the viewpoint of Iran's Ministry of Health and through an one-year horizon. In the national program of vitamin D supplementation, 1,185,211 Iranian high-school students received 50,000 IU vitamin D supplements monthly for nine months. The costs-related data were modified to 2018. The average cost and effectiveness were compared based on the Incremental Cost-Effectiveness Ratio (ICER). RESULTS: Our analytical analysis estimated the 4071.25 (USD / QALY) cost per AQALY gained of the monthly intake of 50,000 IU vitamin D for nine months among adolescents over a one-year horizon. Based on the ICER threshold of 1032-2666, vitamin D supplementation was cost-effective for adolescents to prevent adulthood T2DM. It means that vitamin D supplementation costs were substantially less than the costs of T2DM treatments than the no intervention. CONCLUSIONS: Based on the findings, the national vitamin D supplementation program for Iranian adolescents could be a cost-effective strategy to reduce the risk of diabetes in adulthood. From an economic perspective, vitamin D supplementation, especially in adolescents with vitamin D deficiency, would be administrated.


Subject(s)
Diabetes Mellitus, Type 2/prevention & control , Dietary Supplements/economics , National Health Programs/economics , Vitamin D/administration & dosage , Adolescent , Diabetes Mellitus, Type 2/etiology , Humans , Iran
5.
BMC Palliat Care ; 21(1): 5, 2022 Jan 04.
Article in English | MEDLINE | ID: mdl-34980096

ABSTRACT

BACKGROUND: Older advanced stage cancer patients, with changes in nutritional status, represent an important demand for palliative care. The aim was to determine the effects of 4 weeks of chocolate consumption on the nutritional status of older cancer patients in palliative care. METHODS: Older cancer patients in palliative care with ambulatory (n = 46) monitoring were randomized to control (CG, n = 15), intervention with 55% cocoa chocolate (IG1, n = 16) and intervention with white chocolate (IG2, n = 15) groups and evaluated before and after 4 weeks for nutritional status (primary outcome), evaluated by the Mini Nutritional Assessment tool (MNA). Food consumption, anthropometry, body composition, laboratory parameters and quality of life (QL) with the European Organization for the Research and Treatment of Cancer instrument were also evaluated. RESULTS: IG1 progressed with increased screening (estimated difference [95% CI]: - 1.3 [- 2.2;-0.4], p < 0.01), and nutritional (estimated difference [95% CI]: - 1.3 [- 2.5;-0.1], p = 0.04) scores on the MNA, with no change in anthropometry and body composition. Regarding antioxidant capacity, reduced glutathione levels increased (estimated difference [95% CI]: - 0.8 [- 1.6;-0.02], p = 0.04) and malondealdehyde levels decreased in IG2 (estimated difference [95% CI]:+ 4.9 [+ 0.7;+ 9.1], p = 0.02). Regarding QL, functionality improved in IG1, with higher score in the functional domain (estimated difference [95% CI]:-7.0 [- 13.3;-0.7], p = 0.03). CONCLUSIONS: The consumption of chocolate with a greater cocoa content may contribute to the improvement of the nutritional status and functionality among older cancer patients in palliative care. The consumption of white chocolate was associated with improved oxidative stress. TRIAL REGISTRATION: A randomized clinical trial (ClinicalTrials.gov NCT04367493 ).


Subject(s)
Chocolate , Neoplasms , Humans , Neoplasms/complications , Neoplasms/therapy , Nutritional Status , Palliative Care , Quality of Life
6.
Arthritis Res Ther ; 24(1): 5, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980230

ABSTRACT

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic and complex multi-system autoimmune disorder. Higher risks of hematological malignancies (HM) were observed in SLE patients, which was associated with higher mortality. The mechanism and risk factors of HM oncogenesis in SLE patients are still under investigation. The aim of this study was to explore clinical characteristics, risk factors, and prognosis of SLE patients with or without HM in the Chinese population. METHODS: A retrospective, case-controlled study was conducted in 72 SLE patients between January 2013 and December 2020. Clinical and laboratory data were collected and compared between the two groups of patients with HM and those without HM. Logistic regression analysis was performed to determine risk factors of HM oncogenesis. The survival rate was estimated by Kaplan-Meier methods and Cox proportional hazards regression analysis. RESULTS: Among 72 SLE patients in this study, fifteen complicated with HM and 57 without HM were identified. The incidence rate of HM was approximately 0.24% with elevated standardized incidence ratios of lymphoma and leukemia (27.559 and 12.708, respectively). Patients with HM were older when diagnosed with SLE, with a higher frequency of infection and splenomegaly, lower levels of hemoglobin and high-density lipoprotein compared with those without HM. Fewer patients with HM expressed positive anti-dsDNA antibody (26.7% vs 66.7%, P = 0.005) or received hydroxychloroquine treatment (40.0% vs 86.0%, P = 0.001). Older age at SLE diagnosis (OR=1.122, 95% CI: 1.037-1.214) was regarded as an independent risk factor of HM oncogenesis. Female (RR= 0.219, 95% CI: 0.070-0.681) and hydroxychloroquine (RR= 0.281, 95% CI: 0.094-0.845) were protective factors of mortality in SLE patients. CONCLUSIONS: SLE patients with an older age are at an increased risk of HM carcinogenesis. The prognosis of male patients with SLE tends to be poorer whether complicated with HM. The association of antinuclear antibody spectrum, medication, and HM oncogenesis in SLE needs further investigation.

7.
Trials ; 23(1): 8, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980233

ABSTRACT

BACKGROUND: Lung function is highly age-dependent as it decreases in varying degrees with age, even in healthy people. Decreased lung function results in less elastic lung tissue, reduced chest wall compliance, reduced area for gas exchange, and even a variety of chronic diseases. Traditional Chinese health exercise (TCHE) has three components: "breath regulation," "body regulation," and "heart regulation," which play an important role in the improvement of lung function. However, which component has the most significant effect on lung functioning remains unclear. Therefore, depending on the modality of conditioning, TCHEs will be divided into three exercise intervention groups: breath regulation group, body regulation group, and heart regulation group, in order to explore the magnitude of the effect of the different modalities of conditioning on the improvement of lung function. METHODS: The prospective, parallel, single-blind, randomized controlled trial will evaluate the effects of different conditioning methods of TCHE on lung function in middle-aged and elderly people. The study subjects are healthy middle-aged and elderly adults, who will be randomly divided into the "breath regulation group," "body regulation group," "heart regulation group," and "control group." The control group will receive health education. Health education and exercise intervention in the three intervention groups will be provided for 6 months, 5 times a week, with each session lasting 60 min. The outcomes of interest include changes in the pulmonary function tests measured at baseline and 3 and 6 months after the beginning of the intervention. The primary outcome is the forced vital capacity (FVC), while the secondary outcomes include forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio, vital capacity (VC), and maximal voluntary ventilation (MVV). DISCUSSION: This study will assess the effects of different conditioning methods of TCHE on lung function in middle-aged and elderly people. The final findings of this study will validate the effectiveness and safety of TCHE on lung function interventions in middle-aged and elderly people. TRIAL REGISTRATION: China Clinical Trial Registry ChiCTR2100052687 . Registered on November 3, 2021.


Subject(s)
Lung , Adult , Aged , China , Humans , Middle Aged , Prospective Studies , Randomized Controlled Trials as Topic , Single-Blind Method , Vital Capacity
8.
Trials ; 23(1): 7, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980208

ABSTRACT

BACKGROUND: Excess weight gain in young adulthood is associated with future weight gain and increased risk of chronic disease. Although multimodal, technology-based weight-loss interventions have the potential to promote weight loss among young adults, many interventions have limited personalization, and few have been deployed and evaluated for longer than a year. We aim to assess the effects of a highly personalized, 2-year intervention that uses popular mobile and social technologies to promote weight loss among young adults. METHODS: The Social Mobile Approaches to Reducing Weight (SMART) 2.0 Study is a 24-month parallel-group randomized controlled trial that will include 642 overweight or obese participants, aged 18-35 years, from universities and community colleges in San Diego, CA. All participants receive a wearable activity tracker, connected scale, and corresponding app. Participants randomized to one intervention group receive evidence-based information about weight loss and behavior change techniques via personalized daily text messaging (i.e., SMS/MMS), posts on social media platforms, and online groups. Participants in a second intervention group receive the aforementioned elements in addition to brief, technology-mediated health coaching. Participants in the control group receive a wearable activity tracker, connected scale, and corresponding app alone. The primary outcome is objectively measured weight in kilograms over 24 months. Secondary outcomes include anthropometric measurements; physiological measures; physical activity, diet, sleep, and psychosocial measures; and engagement with intervention modalities. Outcomes are assessed at baseline and 6, 12, 18, and 24 months. Differences between the randomized groups will be analyzed using a mixed model of repeated measures and will be based on the intent-to-treat principle. DISCUSSION: We hypothesize that both SMART 2.0 intervention groups will significantly improve weight loss compared to the control group, and the group receiving health coaching will experience the greatest improvement. We further hypothesize that differences in secondary outcomes will favor the intervention groups. There is a critical need to advance understanding of the effectiveness of multimodal, technology-based weight-loss interventions that have the potential for long-term effects and widespread dissemination among young adults. Our findings should inform the implementation of low-cost and scalable interventions for weight loss and risk-reducing health behaviors. TRIAL REGISTRATION: ClinicalTrials.gov NCT03907462 . Registered on April 9, 2019.


Subject(s)
Mobile Applications , Universities , Adult , Humans , Obesity/diagnosis , Obesity/prevention & control , Overweight , Randomized Controlled Trials as Topic , Weight Gain , Weight Loss , Young Adult
9.
J Infect Dis ; 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34979029

ABSTRACT

OBJECTIVE: To quantify the potential decline in dynamic lung volumes following coronavirus disease 2019 (COVID-19) in the general population. METHODS: A prospective matched cohort study of adult Copenhagen General Population Study (CGPS) participants with a pre-pandemic spirometry available. CGPS individuals with a positive SARS-CoV-2 polymerase chain reaction (PCR) test performed a repeat spirometry, a questionnaire regarding respiratory symptoms and a diffusing capacity test for carbon monoxide. A matched uninfected CGPS control sample was used, and simple regression and linear mixed effect models were computed to study lung function decline. RESULTS: A total of 606 were included. 92/107 (85.9%) of individuals with a positive SARS-CoV-2 PCR test experienced COVID-19 symptoms and 12 (11.2%) were hospitalized. Spirometry was performed at a median (interquartile range) of 5.6 (3.9-12.8) months after positive SARS-CoV-2 PCR test. COVID-19 was associated with an adjusted 7.3 mL (95%CI: 0.3-14.3) and 22.6 mL (95%CI: 13.1-32.0) steeper decline in annual FEV1 and FVC or a total of 113.8 and 301.3 ml lower FEV1 and FVC from baseline to follow up. Results were robust in analyses restricted to individuals not requiring hospitalization. CONCLUSION: COVID-19 related decline of dynamic lung volumes in the general population not requiring hospitalization were small but measurable.

11.
Zhonghua Nei Ke Za Zhi ; 61(1): 12-50, 2022 Jan 01.
Article in Chinese | MEDLINE | ID: mdl-34979769

ABSTRACT

According to the data of seventh national census in China, the elderly population (≥60 years old) accounts for 18.7% (260.4 million) of the total population in 2020. Among them, 30% are diabetes (78.13 million, and more than 95% being type 2 diabetes). Diabetic complications caused by poor glycemic control are the main risk factors influencing the healthy and survival of the elderly, and thus, diabetes prevention and treatment has been to be one of the key actions of Healthy China (2019-2030). The present guideline-"Clinical guidelines for prevention and treatment of type 2 diabetes mellitus in the elderly in China (2022 edition)" is formulated on the basis of the " Expert consensus of the diagnosis and treatment measures for Chinese elderly patients with type 2 diabetes (2018 edition)" and summarizes the domestic and foreign related guidelines for elderly diabetes and research information. The aim of the guide is to optimize the elderly diabetes prevention and control concept, to promote the implementation of standardized clinical prevention, diagnosis and treatment strategy and to improve the level of overall management of diabetes in the elderly.


Subject(s)
Diabetes Complications , Diabetes Mellitus, Type 2 , Hyperglycemia , Aged , China/epidemiology , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/prevention & control , Humans , Middle Aged , Risk Factors
12.
Intern Med ; 61(1): 37-48, 2022.
Article in English | MEDLINE | ID: mdl-34980759

ABSTRACT

Objective In this study, we investigated whether and how the COVID-19 pandemic affected glycemic control and blood pressure (BP) control in patients with diabetes mellitus (DM). Methods DM patients whose HbA1c level was measured regularly before and after the declaration of a state of emergency were included in this study. Some patients were given questionnaires about changes in their lifestyle to determine the factors affecting glycemic control and BP control. Results The median HbA1c level of the 804 patients increased significantly from 6.8% before the state of emergency to 7.1% and 7.0% during and after the state of emergency, respectively. This was in contrast to the decrease one year earlier due to seasonal variations. In the 176 patients who responded to the questionnaire, the HbA1c level also increased significantly during and after the state of emergency. The worsening of glycemic control was more pronounced in the group that had achieved HbA1c of <7% before the state of emergency than in those with higher values. Unlike the rise in HbA1c, the BP did not rise during the state of emergency but did rise significantly afterwards. There was no marked decrease in HbA1c or BP after the state of emergency, even in patients who responded that they were much more careful with their diet, ate less, or exercised more. Conclusions The COVID-19 pandemic worsened glycemic control and BP control, even in patients who perceived no marked change in their diet or exercise, suggesting that more active lifestyle guidance is necessary for good treatment of DM patients.


Subject(s)
COVID-19 , Diabetes Mellitus, Type 2 , Diabetes Mellitus , Blood Glucose , Blood Pressure , Diabetes Mellitus/epidemiology , Diabetes Mellitus, Type 2/epidemiology , Glycated Hemoglobin A/analysis , Glycemic Control , Humans , Japan/epidemiology , Pandemics , SARS-CoV-2
13.
Contemp Clin Trials Commun ; 25: 100878, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34977421

ABSTRACT

Background: Insulin-dependent diabetes is a challenging disease to manage and involves complex behaviors, such as self-monitoring of blood glucose. This can be especially challenging in the face of socioeconomic barriers and in the wake of the COVID-19 pandemic. Digital health self-monitoring interventions and community health worker support are promising and complementary best practices for improving diabetes-related health behaviors and outcomes. Yet, these strategies have not been tested in combination. This protocol paper describes the rationale and design of a trial that measures the combined effect of digital health and community health worker support on glucose self-monitoring and glycosylated hemoglobin. Methods: The study population was uninsured or publicly insured; lived in high-poverty, urban neighborhoods; and had poorly controlled diabetes mellitus with insulin dependence. The study consisted of three arms: usual diabetes care; digital health self-monitoring; or combined digital health and community health worker support. The primary outcome was adherence to blood glucose self-monitoring. The exploratory outcome was change in glycosylated hemoglobin. Conclusion: The design of this trial was grounded in social justice and community engagement. The study protocols were designed in collaboration with frontline community health workers, the study aim was explicit about furthering knowledge useful for advancing health equity, and the population was focused on low-income people. This trial will advance knowledge of whether combining digital health and community health worker interventions can improve glucose self-monitoring and diabetes-related outcomes in a high-risk population.

14.
Metabol Open ; 13: 100154, 2022 Mar.
Article in English | MEDLINE | ID: mdl-34977524

ABSTRACT

Purpose: Diabetes mellitus (DM) is increasing at an alarming rate throughout the world and its complications of has become a major public health concern in all countries. Glycemic control is the most important predictor for DM related complications and deaths. However information on glycemic control remains scarce in Ethiopia including our study area. Hence, the aim of this study was to assess the magnitude and factors associated with poor glycemic control among diabetic outpatients at West Shewa public Hospitals, Ethiopia. Methods: A facility-based cross-sectional study was conducted from June 01 to September 30, 2020. Poor glycemic control was assessed by glycated hemoglobin level and a systematic random sampling method was employed to select participants. An interviewer-administered structured questionnaire was used and the data entered into Epi data version 3.1 and exported into SPSS version 22 for analysis. Logistic regression was conducted to identify predictors of poor glycemic control. A p-value of <0.05 was considered statistically significant. Results: A total of 390 participants were involved in the study with mean age of 46.45 (±15.6) years. The study finding showed that the prevalence of poor glycemic control was found to be 63.8%. Age of ≥50 years (AOR = 2.77; 95% CI: 0.15,0.85), being single (AOR = 2.55; 95% CI: 0.179,.857), having high low-density lipoprotein cholesterol (AOR = 3.44; 95% CI: 1.65, 7.12), being female gender (AOR = 2.4; 95%CI: 0.31,0.816), alcohol intake (AOR = 1.88; 95% CI: 1.135, 3.1) and presence of diabetic peripheral neuropathy (AOR = 1.24; 1.1,1.39) were associated with poor glycemic control. Conclusion: About two-thirds of participants had poor blood glucose control. Increased age, high low-density lipoprotein cholesterol, family history of diabetes, being single, being female, diabetic peripheral neuropathy and alcohol intake were associated with poor glycemic control. Hence, effort should be made towards reducing these factors among DM patients by the concerned body.

15.
Vaccine X ; 10: 100135, 2022 Apr.
Article in English | MEDLINE | ID: mdl-34977553

ABSTRACT

Purpose: Given their negative influence on community health, vaccine hesitancy and resistance are emerging challenges that require healthcare intervention. Therefore, this study aimed to assess the impact of physician-pharmacist collaborative health coaching on rates of hesitancy and resistance for a COVID-19 vaccine. Methods: After an initial assessment of rates of hesitancy and resistance for a COVID-19 vaccine was conducted, hesitant and resistant participants were approached, recruited, and randomized into an active and control group. Pharmacists-physicians collaborative coaching intervention was delivered to active group subjects over two months through Facebook live sessions. The outcome measures were assessed in both groups before coaching, directly after coaching, and a month after coaching. Results: The proportions of hesitancy and resistance for a COVID-19 vaccine among subjects in the active group were significantly reduced from 64.3% and 35.7% before coaching to 20.1% and 7.8% directly after coaching, respectively. These proportions were further reduced to 11.1% and 3.3% a month after coaching, respectively. Furthermore, the mean scores for knowledge on, and attitude towards COVID-19 vaccine were significantly increased from 4.6 ± 1.8 and 4.1 ± 1.7 before coaching to 7.5 ± 3.1 and 8.9 ± 3.8 directly after coaching, respectively. However, the change in mean score of beliefs about COVID-19 vaccines among active group subjects was not significant. Conclusion: High rates of hesitancy and resistance for a COVID-19 vaccine were found in Jordan. These rates can be significantly reduced through online pharmacists-physicians collaborative coaching, which can also improve knowledge of and attitude towards COVID-19 vaccines.

16.
Ann Intern Med ; 2022 Jan 04.
Article in English | MEDLINE | ID: mdl-34978850

ABSTRACT

SOURCE CITATION: Joseph P, Roshandel G, Gao P, et al. Fixed-dose combination therapies with and without aspirin for primary prevention of cardiovascular disease: an individual participant data meta-analysis. Lancet. 2021;398:1133-46. 34469765.

17.
Ann Intern Med ; 2022 Jan 04.
Article in English | MEDLINE | ID: mdl-34978851

ABSTRACT

Asian Americans (AsA), Native Hawaiians, and Pacific Islanders (NHPI) comprise 7.7% of the U.S. population, and AsA have had the fastest growth rate since 2010. Yet the National Institutes of Health (NIH) has invested only 0.17% of its budget on AsA and NHPI research between 1992 and 2018. More than 40 ethnic subgroups are included within AsA and NHPI (with no majority subpopulation), which are highly diverse culturally, demographically, linguistically, and socioeconomically. However, data for these groups are often aggregated, masking critical health disparities and their drivers. To address these issues, in March 2021, the National Heart, Lung, and Blood Institute, in partnership with 8 other NIH institutes, convened a multidisciplinary workshop to review current research, knowledge gaps, opportunities, barriers, and approaches for prevention research for AsA and NHPI populations. The workshop covered 5 domains: 1) sociocultural, environmental, psychological health, and lifestyle dimensions; 2) metabolic disorders; 3) cardiovascular and lung diseases; 4) cancer; and 5) cognitive function and healthy aging. Two recurring themes emerged: Very limited data on the epidemiology, risk factors, and outcomes for most conditions are available, and most existing data are not disaggregated by subgroup, masking variation in risk factors, disease occurrence, and trajectories. Leveraging the vast phenotypic differences among AsA and NHPI groups was identified as a key opportunity to yield novel clues into etiologic and prognostic factors to inform prevention efforts and intervention strategies. Promising approaches for future research include developing collaborations with community partners, investing in infrastructure support for cohort studies, enhancing existing data sources to enable data disaggregation, and incorporating novel technology for objective measurement. Research on AsA and NHPI subgroups is urgently needed to eliminate disparities and promote health equity in these populations.

19.
Oncol Res Treat ; : 1-8, 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34979503

ABSTRACT

INTRODUCTION: Radiation dermatitis (RD) is a side effect of radiation therapy (RT) which is experienced by over 90% of patients being treated for breast cancer. The current clinical trial was conducted to measure the preventative effects of a boron-based gel on several different clinical outcomes (dermatitis, erythema, dry desquamation, and moist desquamation) after 25 radiotherapy sessions. METHODS: This research used a double-blind parallel-group design with a placebo control (n = 76) and randomized group (n = 181), with all participants being between 18 and 75 years old. Fifteen minutes before each radiotherapy, participants in the intervention group were given a gel containing 3% sodium pentaborate pentahydrate, while those in the placebo group received a gel with no chemical substance. Dermatitis, erythema, dry desquamation, and moist desquamation were compared between the 2 groups. RESULTS: At baseline, there were no significant differences between the groups (p > 0.05), except for body mass index. After 14 days of treatment, dermatitis (98.7% vs. 9.9%; p < 0.001), erythema (96.1% vs. 12.2%; p < 0.001), dry desquamation (50% vs. 3.9%; p < 0.001), and moist desquamation (18.4% vs. 0.6%; p < 0.001) were much more common in the placebo group than the intervention group. To prevent dermatitis, erythema, dry desquamation, and moist desquamation in 1 patient, on average, 1.1 (95% confidence interval [CI]: 1.1-1.2), 1.2 (95% CI: 1.1-1.3), 2.2 (95% CI: 1.7-2.9), and 5.6 (95% CI: 3.8-11.0) patients need to be treated, respectively. CONCLUSION: The boron-based gel has a significant preventive effect on several categories of RD which might be used by clinicians in breast cancer.

20.
Eur J Hosp Pharm ; 2022 Jan 03.
Article in English | MEDLINE | ID: mdl-34980596

ABSTRACT

OBJECTIVES: Patients with hypertension in Nepal are often known to have poor medication adherence and quality of life. This randomised controlled trial aimed to evaluate the impact of a hospital pharmacist-delivered individualised pharmaceutical service (P-DIPS) intervention on blood pressure, medication adherence and health-related quality of life (HRQoL) among patients with hypertension in a hospital setting in Nepal. METHODS: In an open trial, 56 adult patients with hypertension who had been receiving antihypertensive medication for ≥6 months were randomly allocated to a control group (n=28) which received the usual care and an intervention group (n=28) which received a P-DIPS along with the usual care. The difference in blood pressure, medication adherence and HRQoL between the two groups at baseline, 2 and 4 months was compared using the Mann-Whitney U test, independent t-test or χ2 tests. RESULTS: Participants were mostly ≥40 years (86%) and female (57%). There were no significant differences in the baseline characteristics between the control (C) and intervention (I) groups. At 2 months, the two groups had a significant improvement in the median (IQR) Morisky-Green-Levine (MGL) Medication Adherence Score (I=1 (2) vs C=2 (2); p<0.001) and the median (IQR) mental component of HRQoL (I=43.6 (9.5) vs C=37.5 (8.6); p=0.013). At 4 months, there were significant differences in the median (IQR) values of all the outcome measures between the groups (systolic blood pressure: I=125 (10) mmHg vs C=130 (15) mmHg, p=0.008; diastolic blood pressure: 80 (14) mmHg vs 90 (10) mmHg, p=0.012; MGL score: I=1 (1) vs C=2 (1), p<0.001; physical component of HRQoL: 45.0 (9.0) vs 40.3 (8.2), p=0.046; and mental component of HRQoL: 47.1 (11.1) vs 38.8 (8.5), p=0.003). CONCLUSIONS: The findings suggest that a P-DIPS intervention in the hospital setting of Nepal has a significant potential to improve blood pressure, medication adherence and HRQoL in patients with hypertension.

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