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1.
J Clin Med ; 11(21)2022 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-36362459

RESUMO

This study investigates the dry eye effect after femtosecond laser-assisted cataract surgery (FLACS) and also compares the risk of postoperative dry eye between FLACS and manual cataract surgery (MCS). We searched various databases between 1 January 2000 and 15 October 2022 and included peer-reviewed clinical studies in our review. Dry eye parameters were extracted at baseline and postoperative day one, week one, one month, and three months. Parameters included were the ocular surface discomfort index (OSDI), tear secretion (tear meniscus height, Schirmer's test), microscopic ocular surface damage (fluorescein staining), and tear stability (first and average tear breakup time). Additionally, the differences of each parameter at each time point were compared between FLACS and MCS. In total, six studies of 611 eyes were included. On postoperative day one, increased, pooled standardised mean differences (SMDs) were noted in the OSDI, tear secretion, tear film instability, and microscopic damage. During postoperative week one, dry eye worsened. Fortunately, dry eye achieved resolution afterwards and nearly returned to the baseline level at postoperative three months. When the parameters were compared between FLACS and MCS, those of FLACS had higher severities, but most were not statistically significant. Dry eye impact was approximately the same in FLACS and MCS at postoperative three months.

2.
BMC Public Health ; 22(1): 1780, 2022 09 20.
Artigo em Inglês | MEDLINE | ID: mdl-36127670

RESUMO

INTRODUCTION: The 21st century was marked by a dramatic increase in adolescent e-cigarette use in the United States (US). The popularity of non-traditional flavor types, including fruit and pastry, is thought to contribute toward growing product use nationally, leading to a variety of federal and state regulations limiting the use of non-traditional flavors in the US. The relationship between flavor type and increased adolescent use suggests a possible link between flavor use and addiction and harm perception. This study assessed if the flavor type used when initiating e-cigarette use predicted addiction and harm perceptions. METHODS: The study utilized data from the multi-wave youth Population Assessment of Tobacco Health Study. It explored the impact initiating e-cigarette use with traditional versus non-traditional flavor types among cigarette users on the outcome variables: e-cigarette addiction and harm perception. Both e-cigarette addiction and harm perception were measured using self-report, Likert scale questionnaires. Descriptive statistics characterized the study variables and linear regression analyses performed to test whether flavor initiation type is associated with addiction and harm perception. RESULTS: The study sample consisted of 1,043 youth (weighted N = 1,873,617) aged 12 to 17 years who reported at least one instance of e-cigarette use. After adjusting for age, age of onset, sex, race and annual household income there was no statistically significant difference in addiction levels between those initiating with traditional versus non-traditional flavors (p = 0.294). Similarly, traditional versus non-traditional flavor initiation did not show a statistically significant difference in adolescent e-cigarette harm perceptions (p = 0.601). CONCLUSIONS: Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Produtos do Tabaco , Vaping , Adolescente , Aromatizantes , Humanos , Percepção , Estados Unidos/epidemiologia , Vaping/epidemiologia
3.
PLoS One ; 17(9): e0274066, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36083972

RESUMO

BACKGROUND: Retinitis pigmentosa (RP) is the most frequent retinal hereditary dystrophy and result in blindness if progresses. Several case reports have revealed the possible association between RP and primary angle-closure glaucoma (PACG). We conducted a population-based study to explore whether RP significantly increased the risk of PACG development. METHODS: Using the Taiwan National Health Insurance Research Database, we enrolled patients with RP into the RP group from 2001 to 2013 and included a comparison group of 1:4 age- and sex-matched individuals without RP. We performed a Cox regression analysis to estimate the crude and adjusted hazard ratios (HRs) of RP for PACG after adjustment for hypertension, diabetes, hyperlipidaemia, chronic kidney disease, and lens subluxation. RESULTS: We enrolled 6223 subjects with RP and 24892 subjects for comparison. The mean age of the cohort was 49.0 ± 18.1 years. The RP group had significantly higher percentages of diabetes mellitus, hypertension, and hyperlipidaemia. The cumulative incidence of PACG in patients with RP was 1.61%, which was significantly higher than that in the comparison group (0.81%, p < 0.0001). According to the univariate Cox regression analysis, the hazard of PACG development was significantly greater in the RP group, with an unadjusted HR of 2.09 (95% confidence interval [CI], 1.64-2.65). The increased risk persisted after adjusting for confounders (adjusted HR = 2.18; 95% CI, 1.76-2.72). CONCLUSION: This nationwide population-based cohort study showed that people with RP are at a significantly greater risk of developing PACG than individuals without RP.


Assuntos
Diabetes Mellitus , Glaucoma de Ângulo Fechado , Hiperlipidemias , Hipertensão , Retinite Pigmentosa , Adulto , Idoso , Estudos de Coortes , Glaucoma de Ângulo Fechado/complicações , Glaucoma de Ângulo Fechado/epidemiologia , Humanos , Hiperlipidemias/complicações , Hiperlipidemias/epidemiologia , Hipertensão/complicações , Hipertensão/epidemiologia , Pessoa de Meia-Idade , Retinite Pigmentosa/complicações , Retinite Pigmentosa/epidemiologia
4.
J Clin Med ; 11(15)2022 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-35893417

RESUMO

Latanoprostene bunod (LBN) 0.024%, a newly approved glaucoma eye drop, is metabolized into latanoprost acid and a nitric oxide (NO)-donating moiety, thus increasing the outflow of aqueous humor through the uveoscleral and trabecular routes, respectively. This study aimed to evaluate the intraocular pressure (IOP)-lowering effect of LBN among patients with open-angle glaucoma (OAG) and ocular hypertension (OHT). The effectiveness of LBN was also compared with timolol maleate 0.5% and latanoprost 0.005%. We searched PubMed and Embase between 1 January 2010, and 31 March 2022 and adopted only peer-reviewed clinical studies in our meta-analysis. A total of nine studies (2389 patients with OAG or OHT) assessing the IOP-reduction effect of LBN were included. Standardized mean differences (SMDs) of IOP between post-treatment time points (2 weeks, 6 weeks, 3 months, 6 months, 9 months, and 12 months) and baseline were calculated. The pooled analysis according to each time point revealed a significant IOP drop after LBN treatment (all p values for SMD < 0.05). In addition, LBN revealed a significantly stronger efficacy in decreasing IOP than timolol maleate 0.5% and latanoprost 0.005% during the follow-up period of three months. No serious side effects of LBN 0.024% were reported. Our study concluded that LBN could achieve good performance for IOP reduction in patients with OAG and OHT. The safety was favorable with no severe side effects.

5.
Interact J Med Res ; 11(2): e39955, 2022 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-35862174

RESUMO

BACKGROUND: COVID-19 spreads via aerosol droplets. The dental profession is at high risk of contracting the virus since their work includes treatment procedures that produce aerosols. Teledentistry offers an opportunity to mitigate the risk to dental personnel by allowing dentists to provide care without direct patient contact. OBJECTIVE: The purpose of this scoping review was to examine the implementation, challenges, strategies, and innovations related to teledentistry during the COVID-19 pandemic lockdown. METHODS: This scoping review evaluated teledentistry use during the pandemic by searching for articles in PubMed and Google Scholar using the search terms teledentistry, tele-dentistry, covid-19, coronavirus, telehealth, telemedicine, and dentistry. Inclusion criteria consisted of articles published in English from March 1, 2020, to April 1, 2022, that were relevant to dentistry and its specialties, and that included some discussion of teledentistry and COVID-19. Specifically, the review sought to explore teledentistry implementation, challenges, strategies to overcome challenges, and innovative ideas that emerged during the pandemic. It followed the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR). This approach is organized into 5 distinct steps: formulating a defined question, using the question to develop inclusion criteria to identify relevant studies, an approach to appraise the studies, summarizing the evidence using an explicit methodology, and interpreting the findings of the review. RESULTS: A total of 32 articles was included in this scoping review and summarized by article type, methodology and population, and key points about the aims; 9 articles were narrative review articles, 10 were opinion pieces, 4 were descriptive studies, 3 were surveys, 2 were integrative literature reviews, and there was 1 each of the following: observational study, systematic review, case report, and practice brief. Teledentistry was used both synchronously and asynchronously for virtual consultations, often employing commercial applications such as WhatsApp, Skype, and Zoom. Dental professionals most commonly used teledentistry for triage, to reduce in-person visits, and for scheduling and providing consultations remotely. Identified challenges included patient and clinician acceptance of teledentistry, having adequate infrastructure, reimbursement, and security concerns. Strategies to address these concerns included clinician and patient training and utilizing Health Insurance Portability and Accountability Act-compliant applications. Benefits from teledentistry included providing care for patients during the pandemic and extending care to areas lacking access to dental care. CONCLUSIONS: Pandemic lockdowns led to new teledentistry implementations, most commonly for triage but also for follow-up and nonprocedural care. Teledentistry reduced in-person visits and improved access to remote areas. Challenges such as technology infrastructure, provider skill level, billing issues, and privacy concerns remain.

6.
J Ophthalmol ; 2022: 9719095, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35783342

RESUMO

Background: Retinitis pigmentosa (RP) is the most common retinal hereditary dystrophy, which can lead to blindness if it progresses. Similarly, open-angle glaucoma (OAG) is a genetic disorder. The similarities in genetic variants and pathophysiology between RP and OAG have been reported. We sought to explore whether patients with RP have a significantly higher risk of OAG development. Methods: We enrolled patients with RP into the RP group through Taiwan's National Health Insurance Research Database from 2001 to 2013; we included a comparison group of 1 : 4 age- and gender-matched individuals without RP. We performed a Cox regression analysis to estimate the crude and adjusted hazard ratios (HRs) for OAG. We adjusted the following confounders in the Cox regression model: age, gender, diabetes mellitus, hypertension, and chronic kidney disease. Results: We enrolled 6,223 subjects with RP and 24,892 subjects for comparison. The mean age of the cohort was 49.0 ± 18.1 years. The RP group had significantly higher percentages of diabetes mellitus, hypertension, and hyperlipidaemia. The cumulative incidence of OAG in patients with RP was 1.57%; this was significantly higher than that in the comparison group (0.58%, p < 0.0001). On univariate Cox regression analysis, the hazard of OAG development was significantly greater in the RP group than in the comparison group with an unadjusted HR of 2.86 (95% confidence interval, 2.21-3.70). The increased risk persisted after adjusting for confounders (adjusted HR = 2.86; 95% CI, 2.21-3.70). Conclusions: This nationwide population-based cohort study showed that people with RP are at a significantly greater risk of developing OAG than individuals without it.

7.
J Dent ; 122: 104157, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35545161

RESUMO

OBJECTIVE: This study used a national database to update and examine current differences in men's and women's oral health and oral health behaviours in the United States. METHODS: Data from the National Health and Nutrition Examination Survey for the 2017-2018 cycle were used to explore the relationship between males and females and their oral health. Multivariate analyses assessed for gender differences in oral health behaviors between genders after controlling for sample demographic characteristics. RESULTS: The final sample consisted of 4,741 participants. Males tended to have fewer dental visits, worse perception of their gum and tooth health, poorer flossing habits, and more root caries. Females were more proactive in visiting dentists and displayed a greater awareness of oral health. Females were less likely to report discussing oral cancer screening with their dentist even though they were screened more often. On examination, males were more often advised to seek urgent dental care than females. All these differences were statistically significant at p<0.05, although the effect size for examination variables was small (Phi <0.1). CONCLUSIONS: Oral health and oral health behaviours demonstrate gender differences with men reporting poorer oral health, poorer oral hygiene habits, and fewer dental visits. These findings suggest gender-targeted strategies have the potential to improve oral health and reduce gender-related disparities. CLINICAL SIGNIFICANCE: This study found that women exhibit better oral health practices and behaviours. These differences may cause a disproportionate burden of oral disease in men and highlight the need for dentists, hygienists, and those interested in dental public health to develop gender-specific strategies to address these inequalities.


Assuntos
Comportamentos Relacionados com a Saúde , Saúde Bucal , Atenção à Saúde , Feminino , Humanos , Masculino , Inquéritos Nutricionais , Fatores Sexuais , Estados Unidos/epidemiologia
8.
J Chin Med Assoc ; 85(6): 730-735, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35507021

RESUMO

Interstitial cystitis/bladder pain syndrome (IC/BPS) is characterized by bladder pain accompanied by irritative urinary symptoms, and typical cystoscopic and histological features. In this pilot study, we assessed the impact of lesion-targeted bladder injection therapy using a biocellular regenerative medicine on patients with refractory IC/BPS. The medicine, which was an autologous emulsified fat (Nanofat) and platelet-rich plasma (PRP) combination, was prepared intraoperatively. Six patients (aged 40-54 years), who completed a standard protocol of four consecutive treatments at 3-month intervals, were followed up at 6 months postoperatively. All patients (100%) reported marked (+3; +3 ~ -3) improvement of their overall bladder conditions. Mean bladder pain (from 8.2 to 1.7; range: 0 ~ 10), IC-related symptoms (from 18.5 to 5.7; range: 0 ~ 20), and bother (from 14.8 to 3.8; range: 0 ~ 16) improved significantly (p < 0.01). The normalization of bladder mucosal morphology with treatments was remarkable under cystoscopic examination, and no significant adverse events were found. The cultured mesenchymal stem cells from Nanofat samples of the six patients were verified in vitro. Our preliminary results suggest novel intravesical therapy with autologous Nanofat plus PRP grafting is safe and effective for refractory IC/BPS. Surgical efficacy might be attributed to an in vivo tissue engineering process.


Assuntos
Cistite Intersticial , Plasma Rico em Plaquetas , Administração Intravesical , Cistite Intersticial/terapia , Feminino , Humanos , Dor/complicações , Dor/tratamento farmacológico , Projetos Piloto
9.
Dent J (Basel) ; 10(4)2022 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-35448047

RESUMO

This study assessed the longitudinal impact of early preventive dental visits on the number of dental operative procedures in a prevention-oriented pediatric dental practice. Inclusion criteria consisted of patients zero to four years of age with at least two years of preventive services provided by the practice. Early preventive visits were the intervention and dental operative procedures were the assessed outcome. The goal was to determine if preventive visits at an early age decreased the number of operative procedures needed by the patient. The patients were divided into two groups: those with older siblings in the practice and those without older siblings in the practice. A secondary outcome was to compare these two patient groups to determine if a child who had older siblings previously treated in this preventive practice had better outcomes than those without siblings in the practice. ANCOVA tests were used to compare the average number of operative procedures in two age groups (<2 years and ≥2 years), and for those with and without dental insurance, in addition to children being younger sibling versus children without sibling, adjusting for the effect of covariates. The study sample consisted of 363 pediatric patients. Patients' age at first visit ranged from 0 to 4 years old (mean = 2.13; SD = 1.15). The average number of operative procedures per year increased as the age at first visit increased (p < 0.05). The average number of operative procedures in two age groups (<2 years and ≥2 years) differed (p < 0.05) with those whose age at first visit ≥2 years experiencing more dental operative procedures than the younger group. The average number of operative procedures was similar between younger siblings (mean = 1.91; SD = 7.44) and children without siblings (mean = 1.54; SD = 2.1) (p > 0.05). The difference in the average number of operative procedures in children with insurance (mean = 1.59; SD = 5.25) and children without insurance (mean = 1.58; SD = 2.38) was non-significant (p > 0.05). More dental cleaning examinations were associated with fewer dental operative procedures (p < 0.05). These findings demonstrate that dental examinations before two years of age and more dental cleaning examinations lead to a decrease in the number of dental operative procedures needed by children.

10.
Healthcare (Basel) ; 10(4)2022 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-35455920

RESUMO

BACKGROUND: Skin cancer is the most common form of cancer, and both clinical and epidemiological data link cumulative solar dosages and the number of sunburns to skin cancer. Each year, more than 5.4 million new cases of skin cancer are diagnosed, incurring a significant health and financial burden. Recommended preventive measures for skin cancer include the use of sunscreen, sun avoidance, and protective clothing. This study used a national database to examine the association of preventive measures with the prevalence of skin cancer, specifically analyzing the preventive measures of sunscreen use, staying in the shade, and wearing long-sleeved shirts. The second aim was to determine which characteristics, if any, correlated with using prevention measures. METHODS: This study analyzed data from the National Health and Nutritional Examination Survey 2015-2016 cycle to examine the association of three preventive measures (using sunscreen, staying in the shade, and wearing long-sleeved shirts) with skin cancer. Logistic regression and chi-square tests were utilized to examine the relationship between skin cancer and these prevention methods. RESULTS: Sunscreen use (OR = 3.752; p < 0.05) was statistically associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts (OR = 6.911; p = 0.064) and staying in the shade (OR = 0.646; p = 0.481) did not emerge as factors significantly associated with a lower prevalence after controlling for gender, race/ethnicity, marital status, income, health insurance, and general health. Additionally, men and individuals of color were less likely to use sunscreen. CONCLUSION: Sunscreen use was associated with a lower prevalence of skin cancer, while wearing long-sleeved shirts and staying in the shade was not significantly linked to lower rates of skin cancer, suggesting that these measures may not be as effective as sunscreen for preventing skin cancer. Men and individuals of color were significantly less likely to use sunscreen. These findings can help guide future education efforts and research regarding skin cancer prevention and suggest the need to develop male-oriented programs to mitigate the gender disparity in employing sun-protection measures.

11.
Arch Public Health ; 80(1): 114, 2022 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395821

RESUMO

BACKGROUND: Despite controversy over their possible health consequences, manufacturers of e-cigarettes employ a variety of marketing media to increase their popularity among adolescents. This study analyzed the relationship between adolescent e-cigarette harm perception and five types of e-cigarette advertising exposures: social media, radio, billboard, newspaper, and television. METHODS: This study used data from Wave 4.5 of the Population Assessment of Tobacco and Health Study (PATH). PATH collects demographic data and interview individuals about issues pertaining to tobacco use, health outcomes, attitudes, and behaviors. This study applied factor analysis to three individual PATH harm perception items to develop a composite harm perception score. Using linear regression, the study explored the relationship of harm perception and participant responses to their recalled viewing of five different types (i.e., newspaper, radio, billboard, television and social media) of advertisements within the past 30 days. A second analysis explored if adjusting for exposure to anti-tobacco messaging and environmental factors such as family approval mitigated the association of harm perception and advertisement types. RESULTS: The study sample consisted of 12,570 (weighted N = 23,993,149) individuals aged 12 to 17 years old. Unadjusted past 30-day exposure to newspaper, radio, billboard, and social media advertising all correlated with a reduced harm perception, but only the associations for newspaper and social media were statistically significant (p<0.05). After adjusting for environmental support factors, exposure to warning labels, and anti-tobacco advertisements, the analysis yielded statistically significant associations between increased e-cigarette harm perception and exposure to radio, billboard, and television advertisements (p<0.05). Adjusting for covariates also reduced the association of marketing and harm perception for all forms of media. CONCLUSION: E-cigarette advertising influences adolescent perceptions of harm in e-cigarette use, particularly for social media and newspaper advertisements. This association weakens when adjusted for covariates such as environmental support and exposure to anti-tobacco marketing. These findings provide evidence for policy makers to continue anti-tobacco marketing and incorporate environmentally supportive strategies such as holistic, family-centered educational approaches to reduce e-cigarette use among adolescents.

12.
Rural Remote Health ; 22(1): 7050, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-35119906

RESUMO

INTRODUCTION: Past studies examined factors associated with rural practice, but none employed newer machine learning (ML) methods to explore potential predictors. The primary aim of this study was to identify factors related to practice in a rural area. Secondary aims were to capture a more precise understanding of the demographic characteristics of the healthcare professions workforce in Utah (USA) and to assess the viability of ML as a predictive tool. METHODS: This study incorporated four datasets - the 2017 dental workforce, the 2016 physician workforce, the 2014 nursing workforce and the 2017 pharmacy workforce - collected by the Utah Medical Education Council. Supervised ML techniques were used to identify factors associated with practice location, the outcome variable of interest. RESULTS: The study sample consisted of 11 259 healthcare professionals with an average age of 46.6 years, of which 36.6% were males and 94.5% Caucasian. Four ML methods were applied to assess model performance by comparing accuracy, sensitivity, specificity and area under the receiver operating characteristic (ROC) curve. Of the methods used, support vector machine performed the best (accuracy 99.7%, precision 100%, sensitivity 100%, specificity 99.4% and ROC 0.997). The models identified income and rural upbringing as the top factors associated with rural practice. CONCLUSION: By far, income emerged as the most important factor associated with rural practice, suggesting that attractive income offers might help rural communities address health professional shortages. Rural upbringing was the next most important predictive factor, validating and updating earlier research. The performance of the ML algorithms suggests their usefulness as a tool to model other databases for individualized prediction.


Assuntos
Serviços de Saúde Rural , Atenção à Saúde , Pessoal de Saúde , Humanos , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Área de Atuação Profissional , Recursos Humanos
13.
Healthcare (Basel) ; 10(2)2022 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-35207015

RESUMO

The influence of familial and social environments plays a significant role in Electronic Nicotine Delivery System (ENDS) use and may contribute to poor oral health among adolescents. This study utilized the Population Assessment of Tobacco and Health (PATH) database and included youths aged 12 to 17 years who reported no history of dental health issues at baseline. Adjusted odds ratios (AOR) were used to examine the association between END-related familial factors and oral health among adolescents in the United States, with statistical significance set at p < 0.05. The sample consisted of 3892 adolescents (weighted N = 22,689,793). Parents' extremely negative reaction towards ENDS when they found their children using ENDS (AOR = 0.309) was connected to a lower risk of oral health issues. The findings suggest that clinicians and policymakers need to consider the roles of these factors when developing strategies to improve oral health outcomes.

14.
Spine Deform ; 10(1): 63-68, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34269996

RESUMO

PURPOSE: PROMIS is becoming the most commonly utilized patient-reported outcome measure (PROM) in adult orthopaedics, but its adoption has lagged in pediatrics. Limited baseline data exists in pediatric-specific orthopaedic diagnoses. The objective of this study was to determine baseline PROMIS scores in patients with idiopathic scoliosis and to evaluate for correlations with the SRS-22. METHODS: This was a retrospective analysis of prospectively collected data from six tertiary care pediatric hospitals between July 2016 and July 2018. Patients with a diagnosis of idiopathic scoliosis, adequate radiographs for measurement and completion of PROMIS and SRS-22 questionnaires from the same visit were included. Only the first visit during the study period was included for each subject. Post-operative patients were excluded. Spearman correlations were performed between four PROMIS domains (Pain interference [PI], Mobility [M], Peer Relationships [PR] and Upper Extremity [UE]) and SRS-22 domains. PROMIS scores are calibrated such that 50 is the median value in a population and 10 points is equivalent to one standard deviation. RESULTS: 986 patients with a mean age of 14.6 years were included, 79.8% of which were female. The mean major curve was 33.0° (range: 10-102). The major curve was thoracic in 56.5%, thoracolumbar in 24.4% and lumbar in 19.1% of subjects. The mean PROMIS domain scores were: Pain Interference 44.5 (IQR 17.7); Mobility 52.7 (IQR 12.5); Peer Relationships 55.7 (IQR 15.0); Upper Extremity 53.4 (IQR 7.7). Correlations existed between PROMIS Pain Interference and SRS-22 pain (r = 0.704, p < 0.001) and PROMIS Mobility and SRS-22 function (r = 0.53, p < 0.001). Significant ceiling effects existed in SRS-22 Function (29.9%), Pain (19.2%) and Satisfaction (30.3%) but only for PROMIS Peer Relationships (42.1%). CONCLUSIONS: PROMIS domain scores for patients with AIS are within normal population limits. PROMIS correlates well with SRS-22 in overlapping domains, and fewer domains demonstrate a ceiling effect. There was no relationship between the magnitude of scoliosis and PROMIS domain scores. LEVEL OF EVIDENCE: II.


Assuntos
Escoliose , Adolescente , Adulto , Criança , Feminino , Humanos , Sistemas de Informação , Medidas de Resultados Relatados pelo Paciente , Estudos Retrospectivos , Escoliose/cirurgia , Inquéritos e Questionários
15.
Muscle Nerve ; 65(2): 193-202, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34787322

RESUMO

INTRODUCTION/AIMS: Scoliosis is a common comorbidity among individuals diagnosed with a dystrophinopathy. We examined associations between clinical predictors and scoliosis in childhood-onset dystrophinopathy. METHODS: The progression and treatment of scoliosis were obtained from data collected by the US population-based Muscular Dystrophy Surveillance, Tracking, and Research Network. Associations between loss of independent ambulation (LoA) and corticosteroid use and scoliosis outcomes (ages at or exceeding Cobb angle thresholds [10°, 20°, 30°]; surgery) were estimated using Kaplan-Meier curve estimation and extended Cox regression modeling. RESULTS: We analyzed curvature data for 513 of 1054 individuals ascertained. Overall, approximately one-half had at least one radiograph and one-quarter had a curvature of at least 20°. The average maximum curvature was 25.0° (SD = 21.5°) among all individuals and 42.8° (SD = 18.8°) among those recommended for surgery. Higher adjusted hazards ratio of curvature (aHR(curvature) [95% confidence interval]) were found among individuals with LoA compared to those without LoA (aHR(10)  = 6.2 [4.4, 8.7], aHR(20)  = 15.3 [7.4, 31.7], aHR(30)  = 31.6 [7.7, 128.9]), among individuals who did not use corticosteroids compared to those who did (aHR(10)  = 1.2 [0.9, 1.7], aHR(20)  = 1.8 [1.1, 2.7], aHR(30)  = 2.3 [1.3, 4.0]), and among non-ambulatory individuals who used corticosteroids after LoA compared to those who did not (aHR(10)  = 1.8 [1.2, 2.8], aHR(20)  = 1.6 [1.0, 2.6], aHR(30)  = 3.6 [1.6, 7.9]). Scoliosis surgery among individuals with LoA who did not use corticosteroids was more than double compared to those who used (aHR = 2.3 [1.3, 4.2]). DISCUSSION: Our retrospective observational study suggests corticosteroids may delay spinal curvature progression and need for scoliosis surgery. Continuing corticosteroids after LoA also showed potential benefits of delaying curvature progression, additional studies are needed to confirm this finding or address the magnitude of benefit.


Assuntos
Distrofia Muscular de Duchenne , Escoliose , Corticosteroides/uso terapêutico , Humanos , Masculino , Distrofia Muscular de Duchenne/complicações , Distrofia Muscular de Duchenne/tratamento farmacológico , Distrofia Muscular de Duchenne/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Escoliose/complicações , Escoliose/diagnóstico por imagem , Escoliose/epidemiologia
16.
Pharmacy (Basel) ; 9(4)2021 Nov 11.
Artigo em Inglês | MEDLINE | ID: mdl-34842823

RESUMO

The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy.

17.
Children (Basel) ; 8(10)2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34682100

RESUMO

BACKGROUND: Therapeutic trials are critical to improving outcomes for individuals diagnosed with Duchenne muscular dystrophy (DMD). Understanding predictors of clinical trial participation could maximize enrollment. METHODS: Data from six sites (Colorado, Iowa, Piedmont region North Carolina, South Carolina, Utah, and western New York) of the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STARnet) were analyzed. Clinical trial participation and individual-level clinical and sociodemographic characteristics were obtained from medical records for the 2000-2015 calendar years. County-level characteristics were determined from linkage of the most recent county of residence identified from medical records and publicly available federal datasets. Fisher's exact and Wilcoxon two-sample tests were used with statistical significance set at one-sided p-value (<0.05) based on the hypothesis that nonparticipants had fewer resources. RESULTS: Clinical trial participation was identified among 17.9% (MD STARnet site: 3.7-27.3%) of 358 individuals with DMD. Corticosteroids, tadalafil, and ataluren (PTC124) were the most common trial medications recorded. Fewer non-Hispanic blacks or Hispanics than non-Hispanic whites participated in clinical trials. Trial participants tended to reside in counties with lower percentages of non-Hispanic blacks. Conclusion: Understanding characteristics associated with clinical trial participation is critical for identifying participation barriers and generalizability of trial results. MD STARnet is uniquely able to track clinical trial participation through surveillance and describe patterns of participation.

18.
Womens Health Rep (New Rochelle) ; 2(1): 245-253, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34318294

RESUMO

Few studies provide detailed findings about the health disparities of women being told by a physician whether they have ever had a human papillomavirus (HPV) infection. This study sought to characterize the prevalence and characteristics associated with women age 18 to 59 years in the United States who report being told they were infected with HPV. This study used data from the National Health and Nutritional Examination Survey. Descriptive statistics were computed on study variables and multiple logistic regression analyses were conducted to explore the association of the study variables with the outcome variable. Sampling weights were applied to produce national estimates of prevalence. The sample consisted of 1,669 females, representative of 75,107,170 females in the United States population. Around 11.5% reported being told that they had an HPV infection, of which 60.9% were White, and 82.9% were born in the United States. White women are 2.0 times more likely to be told they have HPV than Asian women and 2.8 times more likely than Black women. United States-born women were 2.1 times more likely told they had an HPV infection than those foreign born. This study found that among U.S. women, less than 12% reported ever having been told they have had an HPV infection. Epidemiologic findings suggest gaps between ever being told of a previous infection and being diagnosed with a clinically relevant HPV infection. Despite epidemiologic data indicating higher HPV prevalence among those less educated and women of color, these groups were less likely to report ever being told they have an HPV infection than White women, and those with a college degree suggesting communication gaps among these subgroups about HPV infection that might exist. Strategies to address potential gaps in communication among these subgroups can potentially reduce the economic burden and health disparities related to HPV infection.

19.
J Am Coll Health ; : 1-15, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34292141

RESUMO

Objective: In light of COVID-19, leaders issued stay-at-home orders, including closure of higher-education schools. Most students left campus, likely impacting their employment and social network. Leaders are making decisions about opening universities and modality of instruction. Understanding students' psychological, physiological, academic, and financial responses to the shut-down and reopening of campuses can help leaders make informed decisions. Participants: 654 students from a large western university enrolled during the pandemic shutdown. Methods: Students were invited via email to complete an online survey. Results: Students reported stress, depression, loneliness, lack of motivation, difficulty focusing on schoolwork, restless sleep, appetite changes, job loss concerns, and difficulties coping. Most wanted to return to campus and felt social/physical distancing was effective but were mixed in terms of testing or masks. Conclusions: Moving to remote learning created physical and psychological stress. Students want to return to campus but do not want to take risk-reducing measures.

20.
Drug Des Devel Ther ; 15: 2577-2591, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34168430

RESUMO

INTRODUCTION: Novel radiotracer development for imaging dopamine transporters is a subject of interest because although [99mTc]TRODAT-1, [123I]ß-CIT, and [123I]FP-CIT are commercially available; 99Mo/99mTc generator is in short supply and 123I production is highly dependent on compact cyclotron. Therefore, we designed a novel positron emission tomography (PET) tracer based on a tropane derivative through C-2 modification to conjugate NOTA for chelating 68Ga, a radioisotope derived from a 68Ge/68Ga generator. METHODS: IPCAT-NOTA 22 was synthesized and labeled with [68Ga]GaCl4 - at room temperature. Biological studies on serum stability, LogP, and in vitro autoradiography (binding assay and competitive assay) were performed. Furthermore, ex vivo autoradiography, biodistribution, and dynamic PET imaging studies were performed in Sprague Dawley rats. RESULTS: [68Ga]IPCAT-NOTA 24 obtained had a radiochemical yield of ≥90% and a specific activity of 4.25 MBq/nmol. [68Ga]IPCAT-NOTA 24 of 85% radiochemical purity (RCP%) was stable at 37°C for up to 60 minutes in serum with a lipophilicity of 0.88. The specific binding ratio (SBR%) reached 15.8 ± 6.7 at 60 minutes, and the 85% specific uptake could be blocked through co-injection at 100- and 1000-fold of the cold precursor in in vitro binding studies. Tissue regional distribution studies in rats with [68Ga]IPCAT-NOTA 24 showed striatal uptake (0.02% at 5 minutes and 0.007% at 60 minutes) with SBR% of 6%, 25%, and 62% at 5-15, 30-40, and 60-70 minutes, respectively, in NanoPET studies. The RCP% of [68Ga]IPCAT-NOTA 24 at 30 minutes in vivo remained 67.65%. CONCLUSION: Data described here provide new information on the design of PET probe of conjugate/pendent approach for DAT imaging. Another chelator or another direct method of intracranial injection must be used to prove the relation between [68Ga]IPCAT-NOTA 24 uptake and transporter localization.


Assuntos
Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Radioisótopos de Gálio/química , Compostos Heterocíclicos com 1 Anel/química , Tomografia por Emissão de Pósitrons/métodos , Animais , Autorradiografia/métodos , Compostos Heterocíclicos com 1 Anel/síntese química , Masculino , Ratos , Ratos Sprague-Dawley , Fatores de Tempo , Distribuição Tecidual
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