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3.
Medicine (Baltimore) ; 98(37): e17092, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517832

RESUMO

BACKGROUND: Low back pain (LBP) is a major health problem around the world. Two previous meta-analyses showed that the spa therapy has a positive effect on reducing pain among patients with LBP based on studies published before 2006 and studies published between 2006 and 2013. In recent years, more studies reported the effect of spa therapy on treating chronic low back pain (CLBP). Our study aimed to update the meta-analysis of randomized controlled trials (RCTs) about the effect of spa therapy on treating CLBP and to examine the effect of spa therapy based on different interventions. METHODS: PubMed, Embase, Web of Science, and Cochrane Library were searched until May 2018 to identify RCTs about spa therapy among patients with CLBP. Summary effect estimates were calculated by using a random-effects model. The quality of each eligible study was evaluated by Jadad checklist. RESULTS: Twelve studies met the inclusion criteria for the systematic review and were included in meta-analysis. There was a significant decrease in pain based on visual analogue scale (VAS) (mean difference [MD] 16.07, 95% confidence interval [CI] [9.57, 22.57], P < .00001, I = 88%, n = 966), and lumbar spine function in Oswestry disability index (ODI) (MD 7.12, 95% CI [3.77, 10.47], P < .00001, I = 87%, n = 468) comparing spa therapy group to control group. Methodological assessment for included studies showed that the study's quality is associated with lacking blinding. CONCLUSION: This updated meta-analysis confirmed that spa therapy can benefit pain reliving and improve lumbar spine function among patients with CLBP. Physiotherapy of subgroup analysis indicated that it can improve lumbar spine function. However, these conclusions should be treated with caution due to limited studies. More high-quality RCTs with double-blind design, larger sample size, and longer follow-up should be employed to improve the validity of study results.


Assuntos
Banhos/normas , Dor Lombar/terapia , Banhos/métodos , Dor Crônica/terapia , Humanos , Medição da Dor/métodos
4.
Drug Alcohol Depend ; 204: 107458, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31494445

RESUMO

BACKGROUND: The growing use of prescription opioids and benzodiazepines has become a major health threat in the United States, so it is important to document their use among adults to inform health policies or interventions. METHODS: This study included 81,186 adults ages 18 and older from 2015 and 2016 National Survey on Drug Use and Health. Participants' self-reported medical and nonmedical use of prescription opioids and/or benzodiazepines in the past year was assessed along with their demographic characteristics. RESULTS: In 2015-2016, 41.13% of adults reported using prescription opioids and/or benzodiazepines in the past year; 8.24% reported both, 28.59% reported prescription opioids only, and 4.30% reported benzodiazepines only. The majority of adults used the drugs for medical purposes, including 71.35% of participants who reported both drugs in the past year, 90.36% of those who reported prescription opioids only, and 86.24% of those who reported benzodiazepines only. Younger adults ages 18-34 were more likely to use prescription opioids and/or benzodiazepines for nonmedical purposes compared to adults ages 35 and over. CONCLUSIONS: In the United States, the proportion of adults who used prescription opioids and/or benzodiazepines in the past year was high; most of them reported using these drugs for medical purposes. Special attention is needed to prevent potentially unnecessary medical co-prescribing of these drugs, particularly among younger adults, who were more likely report nonmedical use of both drugs than older adults.

5.
BMC Public Health ; 19(1): 421, 2019 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-31014288

RESUMO

BACKGROUND: There has been a limited recognition of hypertension and diabetes in China which has compromised optimal treatment. It is not clear if a screening program implemented by a national health survey has improved awareness and management of these conditions. METHODS: The China Health and Retirement Longitudinal Study (CHARLS) is an ongoing longitudinal health survey conducted since 2011 among Chinese people aged 45 years and older. Participants have been assessed every two years by interviews, physical examinations, and fasting glucose samples were taken in 2011. In 2013 and 2015, participants were asked about awareness and management of selected chronic diseases, and they first became aware of these conditions. RESULTS: Of the 11,000+ participants screened in 2011, 4594 were identified with hypertension and 1703 with diabetes by medical examinations. Over 80% of the middle-aged and elderly Chinese diagnosed with hypertension and/or diabetes in 2011 reported in 2015 that they were unaware of the disease(s). Although some improvement was observed between 2011 and 2015, the main reason for the increase in awareness was a medical examination initiated by the study participant (over 75%), by their work unit or community (12-15%), and rarely (less than 3%) by the CHARLS examination. Participants with a rural household registration status and lower BMI were the most likely to be unaware and to remain unaware of their condition(s). CONCLUSIONS: Disease screening in CHARLS did not lead to significant improvements in awareness of hypertension and diabetes. Improvements should be made by the systematic feedback of screening results to survey participants and the monitoring of disease awareness over time. This will be essential to improve disease recognition and facilitate optimal management.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/epidemiologia , Idoso , China/epidemiologia , Doença Crônica , Diabetes Mellitus Tipo 2/prevenção & controle , Feminino , Inquéritos Epidemiológicos , Humanos , Hipertensão/prevenção & controle , Estudos Longitudinais , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Prevalência , Aposentadoria , População Rural
8.
BMC Surg ; 18(1): 72, 2018 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-30213265

RESUMO

Following publication of the original article [1], the authors reported that one of the authors' names is spelled incorrectly.

9.
BMC Surg ; 18(1): 63, 2018 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-30126403

RESUMO

BACKGROUND: No consensus exists regarding the best reconstruction style after total gastrectomy (TG). Roux-en-Y oesophagojejunostomy is a simple option for gastrointestinal tract reconstruction. Recently, jejunal pouch reconstruction has been suggested as an appropriate approach. We compared the postoperative outcomes of the two surgical approaches using a well-characterized cohort of gastric carcinoma patients. METHODS: A total of 60 patients who underwent TG were divided into two groups according to the reconstruction style. Both groups were compared regarding patient characteristics, perioperative data and quality of life (QoL), which was assessed using the Spitzer QoL index (QLI) and Visick grade. The incidence of long-term surgery-related complications, including reflux oesophagitis, dumping syndrome, and retention syndrome, was also compared to evaluate postoperative restoration. RESULTS: Both study groups were comparable with respect to general patient characteristics. No mortality or no significant differences in surgery-related data were found except in the operation time. Compared to Orr Roux-en-Y reconstruction, pouch reconstruction was associated with a longer procedure time, a lower incidence of dumping/retention syndrome and better QoL parameters (p < 0.05). CONCLUSION: In this study, jejunal pouch reconstruction after TG was superior to the traditional Roux-n-Y oesophagojejunostomy with respect to improved dietary intake and QoL.


Assuntos
Anastomose em-Y de Roux/métodos , Gastrectomia/métodos , Jejuno/cirurgia , Neoplasias Gástricas/cirurgia , Parede Abdominal/cirurgia , Anastomose Cirúrgica/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Período Pós-Operatório , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/métodos
10.
BMC Med Educ ; 18(1): 63, 2018 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-29609654

RESUMO

BACKGROUND: Although the flipped classroom model has been widely adopted in medical education, reports on its use in graduate-level public health programs are limited. This study describes the design, implementation, and evaluation of a flipped classroom redesign of an introductory epidemiology course and compares it to a traditional model. METHODS: One hundred fifty Masters-level students enrolled in an introductory epidemiology course with a traditional format (in-person lecture and discussion section, at-home assignment; 2015, N = 72) and a flipped classroom format (at-home lecture, in-person discussion section and assignment; 2016, N = 78). Using mixed methods, we compared student characteristics, examination scores, and end-of-course evaluations of the 2016 flipped classroom format and the 2015 traditional format. Data on the flipped classroom format, including pre- and post-course surveys, open-ended questions, self-reports of section leader teaching practices, and classroom observations, were evaluated. RESULTS: There were no statistically significant differences in examination scores or students' assessment of the course between 2015 (traditional) and 2016 (flipped). In 2016, 57.1% (36) of respondents to the end-of-course evaluation found watching video lectures at home to have a positive impact on their time management. Open-ended survey responses indicated a number of strengths of the flipped classroom approach, including the freedom to watch pre-recorded lectures at any time and the ability of section leaders to clarify targeted concepts. Suggestions for improvement focused on ways to increase regular interaction with lecturers. CONCLUSIONS: There was no significant difference in students' performance on quantitative assessments comparing the traditional format to the flipped classroom format. The flipped format did allow for greater flexibility and applied learning opportunities at home and during discussion sections.


Assuntos
Educação de Pós-Graduação/métodos , Epidemiologia/educação , Saúde Pública/educação , Desempenho Acadêmico , Humanos , Aprendizagem , Aprendizagem Baseada em Problemas , Inquéritos e Questionários
11.
Sci Rep ; 7(1): 12503, 2017 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-28970510

RESUMO

Glycyrrhetinic acid monoglucuronide (GAMG) is a great value-added and has considerable commercial interest due to its strong pharmacological activities and functional low-calorie sweetener. However GAMG is quite rare in natural plants, and it must be prepared from glycyrrhizin (GL) by hydrolysing one terminal glucuronic acid. ß-Glucuronidase is the key enzyme in the biotransformation of GL to GAMG, but its activities need to be enhanced to facilitate the industrial large-scale production of GAMG. In this study, we identified that isoliquiritigenin (ISL), as one of chemical compositions from the total flavonoids glycyrrhiza (TFG), can significantly enhance ß-glucuronidase activity in vitro. Measurements using high-performance liquid chromatography (HPLC) showed that the activity of ß-glucuronidase could be increased by 2.66-fold via the addition of ISL to a ß-glucuronidase solution that contained GL at a 3:10 molar ratio of ISL to GL. ISL was concluded to be an activator because ISL could reduce the Km and Ea of ß-glucuronidase reacting with GL. This study sheds new light on the mechanism of ß-glucuronidase and helps to make industrial production of GAMG through fermentation feasible.


Assuntos
Chalconas/química , Proteínas Fúngicas/química , Glucuronidase/química , Glucuronídeos/síntese química , Ácido Glicirretínico/análogos & derivados , Glycyrrhiza/química , Ácido Glicirrízico/química , Biocatálise , Biotransformação , Cromatografia Líquida de Alta Pressão , Proteínas Fúngicas/isolamento & purificação , Glucuronidase/isolamento & purificação , Ácido Glicirretínico/síntese química , Cinética , Penicillium/química , Extratos Vegetais/química
13.
Int J Epidemiol ; 46(4): 1157-1170, 2017 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-28338900

RESUMO

Background: Most Chinese people over 55 years old today have experienced the Great Leap Forward Famine of 1959-61. Many reports suggested that the famine could have profound long-term health effects for exposed birth cohorts. A systematic review and meta-analysis was carried out to summarize reported famine effects on long-term health. Methods: Relevant reports were identified by searching PubMed, Embase, Chinese Wanfang Data and Chinese National Knowledge Infrastructure databases. Long-term health conditions were compared in exposed birth cohorts and unexposed controls. Fixed-effects models and random-effects models were used to combine results on adult overweight, obesity, type 2 diabetes, hyperglycaemia, hypertension, the metabolic syndrome and schizophrenia. The heterogeneity across reports was assessed. Subgroup analyses were carried out using reported famine severity, provincial mortality during famine, sex and other report characteristics. Results: In all, 36 reports were eligible for systematic review and 21 could be used for meta-analysis. The number of events we analysed ranged from 1029 for hyperglycaemia to 8973 for hypertension. As reported by others, overweight, type 2 diabetes, hyperglycaemia, the metabolic syndrome, and schizophrenia were more common among adults born during the famine compared with controls born after the famine. By contrast, there were no increases in overweight [odds ratio (OR) 0.68; 95% confidence interval (CI): 0.27-1.72], type 2 diabetes (OR 0.96; 95% CI: 0.73-1.28), hyperglycaemia (OR 0.99; 95% CI: 0.72-1.36) or the metabolic syndrome (OR 1.11; 95% CI: 1.00-1.22) comparing adults born during the famine with controls born either after or before the famine. For schizophrenia, the effect estimates (OR 1.60; 95% CI: 1.50-1.70, combining control groups) were similar in the two scenarios. Conclusions: Our findings suggest that uncontrolled age differences between famine and post-famine births could explain most effects commonly attributed to the famine. For more reliable estimates of long-term famine effects in China, other analyses will be needed with age-appropriate controls and better information on the severity and timing of the famine in the populations included.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Inanição , Grupo com Ancestrais do Continente Asiático , China , Doença Crônica/epidemiologia , Feminino , Humanos , Gravidez
14.
Elife ; 52016 07 06.
Artigo em Inglês | MEDLINE | ID: mdl-27383050

RESUMO

Metabolic network rewiring is the rerouting of metabolism through the use of alternate enzymes to adjust pathway flux and accomplish specific anabolic or catabolic objectives. Here, we report the first characterization of two parallel pathways for the breakdown of the short chain fatty acid propionate in Caenorhabditis elegans. Using genetic interaction mapping, gene co-expression analysis, pathway intermediate quantification and carbon tracing, we uncover a vitamin B12-independent propionate breakdown shunt that is transcriptionally activated on vitamin B12 deficient diets, or under genetic conditions mimicking the human diseases propionic- and methylmalonic acidemia, in which the canonical B12-dependent propionate breakdown pathway is blocked. Our study presents the first example of transcriptional vitamin-directed metabolic network rewiring to promote survival under vitamin deficiency. The ability to reroute propionate breakdown according to B12 availability may provide C. elegans with metabolic plasticity and thus a selective advantage on different diets in the wild.


Assuntos
Caenorhabditis elegans/genética , Caenorhabditis elegans/metabolismo , Engenharia Metabólica , Redes e Vias Metabólicas/genética , Propionatos/metabolismo , Deficiência de Vitamina B 12 , Animais
15.
Dev Dyn ; 245(9): 925-36, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27294288

RESUMO

BACKGROUND: In C. elegans, germline development and early embryogenesis rely on posttranscriptional regulation of maternally transcribed mRNAs. In many cases, the 3' untranslated region (UTR) is sufficient to govern the expression patterns of these transcripts. Several RNA-binding proteins are required to regulate maternal mRNAs through the 3'UTR. Despite intensive efforts to map RNA-binding protein-mRNA interactions in vivo, the biological impact of most binding events remains unknown. Reporter studies using single copy integrated transgenes are essential to evaluate the functional consequences of interactions between RNA-binding proteins and their associated mRNAs. RESULTS: In this report, we present an efficient method of generating reporter strains with improved throughput by using a library variant of MosSCI transgenesis. Furthermore, using RNA interference, we identify the suite of RNA-binding proteins that control the expression pattern of five different maternal mRNAs. CONCLUSIONS: The results provide a generalizable and efficient strategy to assess the functional relevance of protein-RNA interactions in vivo, and reveal new regulatory connections between key RNA-binding proteins and their maternal mRNA targets. Developmental Dynamics 245:925-936, 2016. © 2016 Wiley Periodicals, Inc.


Assuntos
Proteínas de Caenorhabditis elegans/metabolismo , Caenorhabditis elegans/metabolismo , Regiões 3' não Traduzidas/genética , Animais , Animais Geneticamente Modificados , Caenorhabditis elegans/genética , Proteínas de Caenorhabditis elegans/genética , Regulação da Expressão Gênica no Desenvolvimento/genética , Regulação da Expressão Gênica no Desenvolvimento/fisiologia , Ligação Proteica/genética , Interferência de RNA , RNA Mensageiro Estocado/genética , Proteínas de Ligação a RNA/genética , Proteínas de Ligação a RNA/metabolismo
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