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1.
Eur J Cancer Prev ; 2020 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-32039929

RESUMO

The relationship between hypertension and risk of colorectal cancer (CRC) is unclear. This meta-analysis aims to explore the association between them. Six databases were searched for studies published before August 2019. The pooled relative risk (RR) and 95% confidence intervals (CIs) were calculated to estimate the association between the hypertension and CRC risk. A total of 2841 potentially relevant articles were obtained, and 25 studies with a pooled 1.95 million participants were finally included in the meta-analysis. These results suggested a positive association between hypertension and risk of CRC with a pooled RR of 1.15 (95% CI: 1.08, 1.23). Male patients with hypertension had a 13% (95% CI: 1.06, 1.20) increased risk of CRC. The risk of colon cancer and rectal cancer in male patients was 1.17 (95% CI: 1.01, 1.36) and 1.35 (95% CI: 1.04, 1.74), respectively, while no association between hypertension and the risk of CRC in females was elucidated. This meta-analysis demonstrated that a positive association between hypertension and CRC exists, with male patients having a higher risk of developing CRC than female patients.

2.
Neurol Sci ; 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31930449

RESUMO

OBJECTIVE: Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. METHODS: Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. RESULTS: A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2 = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2 = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2 = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2 = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2 = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. CONCLUSION: Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.

3.
Eur J Clin Pharmacol ; 76(2): 139-147, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31748819

RESUMO

PURPOSE: The aim of this study was to explore the relationship between proton pump inhibitors use and the risk of dementia. METHODS: A comprehensive literature search was conducted in English and Chinese databases from origination to December 2018. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. Cochran's Q test and the I2 statistic were used to evaluate the heterogeneity. Publication bias was assessed by Begg's test and Egger's test. RESULTS: Six studies were included, which contained a total of 166,146 participants. The overall result demonstrated a significant increase in dementia risk with proton pump inhibitors use (HR = 1.29, 95% CI = 1.12-1.49). In subgroup analyses, a significant association was detected between proton pump inhibitors use and the risk of dementia in Europe (HR = 1.46, 95% CI = 1.23-1.73) and among participants aged ≥ 65 years (HR = 1.39, 95% CI = 1.17-1.65). For the factor follow-up time ≥ 5 years, the pooled HR was 1.28 (95% CI = 1.12-1.46), demonstrating a 1.28-fold increase in the risk of dementia among proton pump inhibitors users. In the case of regional impact, participants from Europe showed an overall pooled HR estimate of 1.46 (95% CI = 1.23-1.73). There was no evidence of publication bias. CONCLUSIONS: The overall result of this meta-analysis supports the hypothesis that proton pump inhibitors increase the risk of dementia. Furthermore, high-quality cohort studies are needed to confirm these findings.

4.
J Clin Periodontol ; 47(2): 134-147, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31697412

RESUMO

OBJECTIVE: To evaluate the association between periodontitis and the incidence and mortality of gastrointestinal cancer. METHOD: A comprehensive literature search was conducted to identify all relevant studies published prior to April 2019 according to the established inclusion criteria. The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a random-effects model. RESULTS: We identified 10 studies with 26 estimates of the relationship between periodontitis and gastrointestinal cancer. The HR for the incidence of gastrointestinal cancer in periodontitis was 1.23 (95% CI: 1.10-1.37). Subgroup analyses showed that periodontitis was associated with an increased risk of gastrointestinal cancers in prospective cohort studies and high-quality studies, North American individuals, and individuals 18 years or older, as well as when the dental status was self-reported and when the study was adjusted for smoking. A meta-analysis of nine reports demonstrated that periodontitis was associated with increased mortality from gastrointestinal cancer (HR = 1.59, 95% CI: 1.16-2.16). Additionally, periodontitis was associated with mortality from pancreatic cancer (HR = 2.20, 95% CI: 1.44-3.37); thus, periodontitis may be a risk factor for pancreatic cancer. CONCLUSION: Our meta-analysis demonstrated that periodontitis may be a risk factor for gastrointestinal cancers. Additional prospective cohort studies are warranted to confirm these findings.

5.
J Sleep Res ; 29(1): e12876, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31352687

RESUMO

Recently, emerging studies on the relationship between insomnia, the most common sleep disorder, and cancer have been published, but with inconsistent results. With the development of society and the accelerated pace of life, more and more people experience insomnia. Therefore, it is important to clarify the association. Relevant literature was obtained through a search of seven databases and supplementary searches. After a strict screening, eight cohort studies (seven prospective and one retrospective) involving 578,809 participants and 7,451 cancer events were incorporated into our analysis. The results demonstrate a modest 24% overall increased risk of cancer for individuals with insomnia in comparison to those without insomnia. The sensitivity analysis shows that the correlation between the two is stable. Subgroup analyses show that the risk of developing cancer was significantly higher in studies conducted in women (HR = 1.24; 95% CI, 1.01-1.53), but not in men (HR = 1.28; 95% CI, 0.90-1.80). Similarly, in terms of specific cancer types, the pooled HR was only significantly higher in thyroid cancer (HR = 1.36; 95% CI, 1.12-1.65) and not in other types of cancer (p > 0.05). Our findings suggest that insomnia may serve as an early warning sign of the onset of cancer and provide an opportunity for early detection and early intervention. Our findings should be treated with caution because of the limited number of included studies and potential bias. More additional studies are warranted to provide more information on the carcinogenic effect of insomnia.

6.
Environ Health ; 18(1): 98, 2019 11 20.
Artigo em Inglês | MEDLINE | ID: mdl-31771610

RESUMO

BACKGROUND: Very few studies have focused on the relationship between ambient apparent temperature (AT) and admission of mental and behaviour disorders (MDs). Therefore, a time-series study was conducted in Yancheng, China, to explore the effects of AT on the daily emergency admissions of patients with MDs over the period of 2014-17. METHODS: A quasi-Poisson generalized linear model (GLM) combined with a distributed lag non-linear model (DLNM) was adopted to explore the associations after adjusting for time trend, day of the week, humidity, sunshine duration, rainfall, holidays and air pollutants. In the subgroup analysis, the modification effects of age and sex were also examined. RESULTS: Overall, 8438 cases of MDs emergency admissions were identified. With the apparent temperature with the minimum number of admissions (- 3.4 °C) serving as a reference, a positive correlation emerged between high AT and daily emergency admissions of patients with MDs in Yancheng, China, with the lagged effect of 1 to 5 days. The subgroup analysis demonstrated a positive relationship between AT and MDs emergency admissions among males and individuals younger than 45 years old, with no lagged effect. CONCLUSIONS: The results will provide important scientific evidence for mental health policy-makers and practitioners for possible intervention, especially among the vulnerable populations.

7.
Blood Press ; : 1-10, 2019 Nov 13.
Artigo em Inglês | MEDLINE | ID: mdl-31718311

RESUMO

Purposes: Many studies have indicated that orthostatic hypotension (OH) may be a risk factor for dementia and stroke, but the results have been inconsistent. To further ascertain the links between OH and cognition or stroke, a meta-analysis was performed.Methods: The Chinese Biomedical Database, PubMed, Web of Science, and the Cochrane Library database were searched (up to March 2019) to identify prospective cohort studies that examined the associations between OH and the risks of stroke and dementia among adult populations. Subgroup analyses and meta-regression analyses were conducted to identify sources of heterogeneity. We also performed Begg's test and Egger's test to assess publication bias.Results: A total of 3490 articles were identified, and 18 prospective observational cohort studies were ultimately included. Among these studies, eight prospective studies were about stroke, nine studies were about cognition and one study reported data about both stroke and dementia. Meta-analysis revealed an association between OH and worse cognition (hazard ratio (HR): 1.18, 95% confidence interval (CI): 1.03-1.35, I2 = 69.5%). For dementia, the pooled HR was 1.30, with 95% CI: 1.14-1.48, I2 = 31.0%. In addition, we found that OH was associated with a higher risk of stroke (HR: 1.36, 95% CI = 1.17-1.57, I2 = 67.3%). No publication bias was detected.Conclusion: This meta-analysis provides evidence that OH was associated with worse cognition. OH accounted for a 30% increase in the risk of dementia and a 36% increase in the risk of stroke.

8.
Psychol Health Med ; : 1-12, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31623456

RESUMO

The present study attempted to investigate dynamics and predictors of resilience amongst Chinese children using prospective data. Totally 816 children completed the resilience measurement at baseline and one-year follow-up. Multivariate logistic regression was used to examine associations between high resilience and predictor variables. Mean resilience scores increased during the one-year follow-up (t = -2.35, P = 0.019). Although the proportions of high and low resilience were relatively stable, whereas 28% of children had inconsistent resilience level during the follow-up. Multivariable logistic regression analysis showed that participants' parents having secondary school (adjusted OR (aOR) = 1.67, 95%CI = 1.14-2.44) or higher (aOR = 2.53, 95%CI = 1.51-4.24) education level, and high quality of life (aOR = 1.81, 95%CI = 1.20-2.73) were positively associated with high resilience, whereas moderate family function obstacles (aOR = 0.47, 95%CI = 0.34-0.67), abuse experience (aOR = 0.68, 95%CI = 0.50-0.92), and significant depression symptoms (aOR = 0.47, 95%CI = 0.28-0.77) were negatively associated with high resilience. Results highlight that resilience levels were not merely static trait and improved over one year among Chinese children. Findings would deepen understanding of resilience change and provide potential targets of resilience-focused intervention in children.

9.
Int J Clin Health Psychol ; 19(3): 181-188, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31516496

RESUMO

Background/Objective: Previous studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine. Method: People who use methamphetamine (MA) (N = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms. Results: A total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model R2  = .08, p < .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant. Conclusions: These analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China.

10.
Int. j. clin. health psychol. (Internet) ; 19(3): 181-188, sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184964

RESUMO

Background/Objective: Previous studies have shown that childhood abuse is associated with symptoms of depression. This study aims to examine the prevalence of childhood abuse or neglect and its correlation with depression among a sample of Chinese people who use methamphetamine. Method: People who use methamphetamine (MA) (N = 1,173) were recruited from government-operated drug rehabilitation centres in Anhui province, China. Participants were assessed using the short form of Childhood Trauma Questionnaire and the Beck Depression Inventory-II for childhood abuse or neglect and depression symptoms. Results: A total of 44.6% of people who use MA reported moderate/severe childhood abuse or neglect, and 56.9% of this sample were diagnosed with depression. Emotional abuse, sexual abuse, emotional neglect and physical neglect were revealed to increase the risk of depression. Multivariable regression analyses showed that depression scores were significantly predicted by gender, duration of drug use, sexual abuse and emotional neglect (model R2 = .08, p < .001). The interaction between emotional neglect and duration of drug use on the depression was statistically significant. Conclusions: These analyses indicate that sexual abuse and emotional neglect increase the severity of depression in individuals who use MA in drug rehabilitation centres of China


Antecedentes/Objetivo: Estudios previos han demostrado que el abuso infantil está asociado a síntomas depresivos. El objetivo es investigar la prevalencia del abuso infantil entre consumidores de metanfetaminas en muestras chinas y su correlación con la depresión. Método: Se reclutan consumidores de metanfetamina (MA) del centro de rehabilitación de drogas del gobierno chino (N = 1.173). Los participantes fueron evaluados utilizando la forma corta del Childhood Trauma Questionnaire y el Inventario de Depresión de Beck-II para abuso infantil o negligencia y síntomas depresivos, respectivamente. Resultados: El 44,6% de los consumidores de MA reportaron abuso infantil moderado/grave, de los cuales el 56,9% fueron diagnosticados con depresión leve a grave. El abuso emocional, abuso sexual, abandono emocional y negligencia física fueron asociados al incremente del riesgo de depresión. El análisis de regresión multivariada indica que la depresión se predice de manera significativa según el sexo, la duración del consumo de drogas, el abuso sexual y el grado de negligencia emocional (R2 = 0,08; p <  0,001). El efecto de la negligencia emocional y del tiempo de consumo de drogas sobre la depresión fue significativo. Conclusiones: El abuso sexual y el abandono emocional aumentan la gravedad de la depresión en pacientes de centros de rehabilitación de drogas en China


Assuntos
Humanos , Masculino , Feminino , Criança , Adulto , Abuso Sexual na Infância/psicologia , Depressão/psicologia , Metanfetamina , Transtornos Relacionados ao Uso de Substâncias , Prevalência , Fatores de Risco , Centros de Tratamento de Abuso de Substâncias , Fatores Socioeconômicos
11.
Clin Nutr ; 2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31445779

RESUMO

PURPOSE: The association between famine exposure and type 2 diabetes (T2DM) remains controversial. A meta-analysis was performed to clarify the relation of famine exposure to T2DM risk in detail. METHODS: A systematic literature search was performed in PubMed, Cochrane library, Web of Science, China National Knowledge Infrastructure (CNKI), Sinomed (CBM), Wanfang Data Knowledge Service Platform and China Science and Technology Journal VIP Database. The articles were limited to be available in English or Chinese before 10 April 2019. The pooled relative risk (RR) with 95% confidence interval (CI) was used to estimate the effect of famine exposure on T2DM. The I square value (I2) was used to assess heterogeneity, and the random effects model (REM) was adopted as the pooling method. RESULTS: This meta-analysis included 24 published articles with 1,660,385 subjects. A significant association of famine exposure with increased risk of T2DM was observed (RR = 1.433, 95% CI: 1.101-1.865). The pooled RRs were different in terms of publication year, location, study design, sample size, famine duration and definition of diabetes (criteria). Longer the famine exposure experienced, greater the effect of famine exposure on T2DM would be. Compared to WHO criteria, studies of which diabetes diagnosed by ADA criteria and other criteria might more likely to find this association. Compared to moderate famine exposure, the pooled RR in severe famine was statistically significant. Furthermore, the pooled RR adjusted for the most confounders in females was 1.517 (95% CI: 1.018-2.261). In terms of period of famine exposure, compared to adult exposure, people who exposure famine in fetal, childhood, and adolescent were likely to be diabetes. CONCLUSION: Famine exposure may increase the risk of T2DM. The risk may vary with famine duration, definition of diabetes, gender and period of famine exposure.

12.
J Hum Hypertens ; 33(9): 648-657, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31363149

RESUMO

We performed this meta-analysis to assess the association between intensive systolic blood pressure (SBP)-lowering strategies and heart failure (HF). A comprehensive literature review was conducted using English and Chinese databases from their origination through April 2018. Random-effects models were used to calculate pooled relative risks and 95% confidence intervals. Nine randomized controlled trials including a total of 39,936 hypertensive patients were ultimately included in our meta-analysis. Pooled analysis of these nine trials showed that a treatment target of SBP ≤140 mmHg was associated with a significant reduction in HF risk (RR: 0.73, 95%CI: 0.62-0.87). Furthermore, the pooled analysis of prospective randomized controlled trials indicated a significant association between intensive lowering of SBP and HF risk (RR: 0.75, 95%CI: 0.62-0.90) and showed that intensive lowering of SBP could decrease risk of HF in patients without diabetes mellitus (RR: 0.69, 95%CI: 0.52-0.91) and in those ≥65 years old (RR: 0.72, 95%CI: 0.56-0.93), but this finding was not shown for patients with diabetes mellitus (RR: 0.81, 95%CI: 0.56-1.19) or in those <65 years old (RR: 0.81, 95%CI: 0.56-1.19). When intensive lowering of SBP achieved an SBP ≤ 120 mmHg, a pooled analysis indicated a positive association between SBP and HF risk (RR: 0.75, 95%CI: 0.63-0.89), and a pooled analyses showed that intensive lowering of SBP could decrease risk of HF in patients without diabetes mellitus (RR: 0.71, 95%CI: 0.51-0.98) and in those ≥65 years old (RR: 0.76, 95%CI: 0.58-0.98); however, this result was not found for patients with diabetes mellitus (RR: 0.81, 95%CI: 0.56-1.19) or those <65 years old (RR: 0.81, 95%CI: 0.56-1.19). The existing data support the results of a positive association between intensive SBP-lowering treatment and HF risk, especially for those patients without diabetes and those older than 65 years. However, additional prospective studies are still needed to confirm these associations.

13.
Sci Total Environ ; 685: 1030-1041, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31390694

RESUMO

PURPOSE: The association between meteorological variables and risk of fractures has attracted increasing attentions but remain controversial. Therefore, our main aim is to clarify the association, and also to identify possible susceptible groups. METHODS: Relevant literature was obtained through standard MeSH literature searching seven electronic databases. Because some studies expressed the association as the rate of incidence (IRR) of fractures associated with each 1 °C rise in temperature and 1% increase in relative humidity (RH), some expressed as IRR of fractures for the day with specific climatic variable versus control days, and also the association was expressed as correlations coefficients (COR) in some studies, separated meta-analyses were undertaken, with one based on IRR and another based on COR. RESULTS: A total of 24 studies were included. Results showed that each 1 °C increase was significantly associated with a 3.0% decrease in fracture risk (IRR = 0.970, 95%CI: 0.952-0.988). The day with freezing rain and snow were associated with increased risk for both the lower extremity fracture (freezing rain: IRR = 1.174, 95%CI: 1.022-1.348; snow: IRR = 1.245, 95%CI: 1.050-1.477) and the upper extremity fracture (freezing rain: IRR = 1.376, 95%CI: 1.192-1.588; snow: IRR = 1.548, 95%CI: 1.361-1.761). No significant association was detected between RH, dew, frost, fog, storm and high wind, and fracture. The COR meta-analysis showed that mean temperature (moderately), maximum temperature (moderately), rainfall (weakly) and sunlight duration (weakly) were correlated with fracture occurrence. CONCLUSION: The incidence of fractures was increased in lower temperature, the day with freezing rain, and snow. Other meteorological factors may have some effects on the incidence of fracture. The association maybe stronger for males, lower extremity fracture, and people living in Asia, subtropical zone, low-latitude, and northern hemisphere. Further studies are needed.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Fraturas Ósseas/epidemiologia , Conceitos Meteorológicos , Humanos
14.
J Clin Hypertens (Greenwich) ; 21(8): 1221-1227, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31290595

RESUMO

The relationships between orthostatic hypotension (OH) and some kinds of cardiovascular disease are inconsistent among studies. This updated meta-analysis was conducted in hopes of producing progress on this topic. A systematic database search was performed in electronic databases, including the Chinese Biomedical Database (CBM), PubMed, Web of Science, and the Cochrane Library. Summary hazard ratio (HR) estimates with 95% confidence intervals (CIs) were calculated by a random-effects model. Statistical heterogeneity was assessed with Cochran's Q test and the I2 statistic. From 1462 potentially eligible records, 15 studies met the inclusion criteria. Subjects with OH had a high risk of heart failure (HF) and atrial fibrillation (AF) (pooled HR 1.34, 95% CI 1.17-1.52, P < 0.001 and pooled HR 1.51, 95% CI 1.28-1.79, P < 0.001, respectively). This meta-analysis also showed significant associations between OH and the risks of developing coronary heart disease (CHD) (pooled HR 1.44, 95% CI 1.18-1.75, P < 0.001) and myocardial infarction (MI) (pooled HR 1.52, 95% CI 1.12-2.06, P = 0.008). Our study suggests that OH is positively associated with high risks of HF and AF. Moreover, it may be related to high risks of CHD and MI.

15.
Artigo em Inglês | MEDLINE | ID: mdl-31251367

RESUMO

BACKGROUND: China's capacity to control and prevent emerging and re-emerging infectious diseases is critical to the nation's population health. This study aimed to explore the capacity of Centers for Disease Control and Prevention (CDCs) in China to deal with infectious diseases now and in the future. METHODS: A survey was conducted in 2015 among 973 public health professionals at CDCs in Beijing and four provinces, to assess their capacity to deal with emerging and re-emerging infectious diseases. RESULTS: Although most professionals were confident with the current capacity of CDCs to cope with outbreaks, nearly all indicated more funding was required to meet future challenges. Responses indicated that Yunnan Province faced more challenges than Anhui, Henan and Liaoning Provinces in being completely prepared and able to deal with outbreaks. Participants aged 20-39 years were more likely than those aged 40 and over to believe strategies such as interdisciplinary and international collaborations for disease surveillance and control, would assist capacity building. CONCLUSION: The capacity of China's CDCs to deal with infectious diseases was excellent. However, findings suggest it is imperative to increase the number of skilled CDC staff, financial support, and strengthen county level staff training and health education programs.

16.
Sleep Breath ; 23(4): 1047-1057, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30903565

RESUMO

Previous epidemiological investigations have evaluated the association between gout, serum uric acid levels, and obstructive sleep apnea syndrome (OSAS), but with inconsistent results. We conducted this meta-analysis aiming at providing clear evidence about whether OSAS patients have higher serum uric acid levels and more susceptible to gout. Relevant studies were identified via electronic databases from inception to December 17, 2018. Study selection was conducted according to predesigned eligibility criteria, and two authors independently extracted data from included studies. The hazard ratio (HR) and weighted mean difference (WMD) and their corresponding 95% confidence interval (CI) were derived using random-effects models. We conducted meta-, heterogeneity, publication bias, sensitivity, and subgroup analyses. Eighteen studies, involving a total of 157,607 individuals (32,395 with OSAS, 125,212 without OSAS) and 12,262 gout cases, were included. Results show that serum uric acid levels are elevated in patients with OSAS (WMD = 52.25, 95% CI 36.16-64.33); OSAS did not reach statistical significance as a predictor of gout (but there was a trend, HR = 1.25, 95% CI 0.91-1.70) and that the association between OSAS and serum uric acid was quite robust. OSAS may be a potential risk factor for hyperuricemia and the development of gout and thus, effective OSAS therapy may present as a valuable preventive measure against gout. Still, it is vital to undertake clinical studies with better designing to corroborate these associations and shed new light on it.

17.
AIDS Behav ; 23(11): 3129-3139, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30852728

RESUMO

This study tested a mobile health (mHealth) intervention program entitled WeTest, delivered via the WeChat mobile app, to promote oral HIV self-testing (HIVST) among MSM in Hefei, China. A total of 100 MSM participants enrolled, completed baseline assessment, were randomly assigned to intervention or control, and completed 6-month follow-up surveys. Intervention participants (n = 50) received two oral HIVST kits and access to WeTest, a private WeChat group which provided app-based messages and referrals to health services related to HIV. Control participants (n = 50) received two oral HIVST kits only. All participants received instructions to upload photographic results of their oral HIVST, which were sent to the project counselor via a secure WeChat online portal; immediate contact and referrals were made to any participants who tested HIV-positive. In GEE analyses adjusting for time effects and baseline confounders, intervention participants had significantly higher rates of HIV testing (adjusted rate ratio RR = 1.99, 95% confidence interval (CI) 1.07-3.84) and, in particular, higher rates of testing via oral HIVST (adjusted RR = 2.17, 95% CI 1.08-4.37) compared with the control group. Significant time effects were also found such that all participants, regardless of group allocation, had significantly higher rates of reporting consistent condom use with main partners (adjusted RR = 18.13, 95% CI 5.19-63.31) and with non-main partners (adjusted RR = 5.33, 95% CI 2.35-12.08). Findings from this study provide evidence for the feasibility, acceptability and preliminary effects of this mHealth approach to promoting oral HIVST among MSM in China.


Assuntos
Preservativos/estatística & dados numéricos , Infecções por HIV/diagnóstico , Homossexualidade Masculina/estatística & dados numéricos , Programas de Rastreamento/métodos , Autocuidado/métodos , Telemedicina/métodos , Adulto , China , Homossexualidade Masculina/etnologia , Humanos , Masculino , Programas de Rastreamento/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Sexo Seguro , Testes Sorológicos , Parceiros Sexuais , Inquéritos e Questionários
18.
Pancreas ; 48(2): 142-150, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30640225

RESUMO

OBJECTIVE: The aim of this study was to explore the relationship between statin use and the risk of pancreatic cancer. METHODS: Electronic databases were searched to identify relevant studies published until January 2018. The pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated with random-effects model. Subgroup analyses and sensitivity analysis were also conducted. Cochran Q test and I(2) statistic were used to evaluate the heterogeneity. RESULTS: Twenty-six studies were included that contained more than 3 million participants and 170,000 pancreatic cancer patients. The overall result demonstrated a significant decrease in pancreatic cancer risk with statin use (RR, 0.84; 95% CI, 0.73-0.97; P = 0.000; I(2) = 84.4%). In subgroup analyses, nonsignificant association was detected between long-term statin use and the risk of pancreatic cancer (RR, 0.98; 95% CI, 0.86-1.11; P = 0.718; I(2) = 0.0%). Meanwhile, there was nonsignificant association between the use of lipophilic statins and the risk of pancreatic cancer (RR, 0.98; 95% CI, 0.84-1.15; P = 0.853; I(2) = 27.2%). No publication bias was found in this meta-analysis. CONCLUSIONS: The overall result of this meta-analysis supports the hypothesis that statins have a protective effect on pancreatic cancer. Furthermore, high-quality randomized clinical trials and cohort studies are needed to confirm these findings.


Assuntos
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Neoplasias Pancreáticas/prevenção & controle , Humanos , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/epidemiologia , Prognóstico , Fatores de Proteção , Medição de Risco , Fatores de Risco
19.
J Public Health Policy ; 40(2): 236-252, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30675015

RESUMO

Children with upper respiratory tract infections (URTIs) are among the highest receivers of antibiotics. Using a retrospective cross-sectional study, we described clinical management in rural China of recent URTIs in children. We explored antibiotics using behaviors and associations of caregivers' variables and children's symptoms. Children with URTIs had a high consultation rate and a high prescription rate of antibiotics. For the children, some caregivers adopted, without rationale, 'self-medication' with antibiotics. Children with fever were more likely to be taken to a doctor; among those, children with particular symptoms were more likely to receive a prescription for antibiotics. Disseminating knowledge on antibiotics, and on interpretation and management of URTI symptoms will be important targets for caregiver and physician education and should become routine in training for physicians. Our findings also suggest the need to improve communication between doctors and caregivers, to strengthen regulation of drug sales, and to help caregivers learn when over-the-counter drug purchase without medical consultation is reasonable. These activities can help to improve health of a vast population of children in rural China.


Assuntos
Antibacterianos/uso terapêutico , Cuidadores/estatística & dados numéricos , Política de Saúde , Prescrição Inadequada/estatística & dados numéricos , Infecções Respiratórias/tratamento farmacológico , Adolescente , Adulto , Cuidadores/educação , Criança , Pré-Escolar , China , Estudos Transversais , Feminino , Humanos , Prescrição Inadequada/prevenção & controle , Lactente , Masculino , Pessoa de Meia-Idade , Prática de Saúde Pública , Estudos Retrospectivos , População Rural , Inquéritos e Questionários , Adulto Jovem
20.
J Infect Public Health ; 12(3): 388-394, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30606474

RESUMO

BACKGROUND: Dengue is a significant climate-sensitive disease. Public health professionals play an important role in prevention and control of the disease. This study aimed to explore dengue control and prevention in the context of climate change in China. METHODS: A cross-sectional survey was conducted among 630 public health professionals in 2015. Descriptive analysis and logistic regression were performed. RESULTS: More than 80% of participants from southwest and central China believed climate change would affect dengue. However, participants from northeast China were less likely to believe so (65%). Sixty-nine percent of participants in Yunnan perceived that dengue had emerged/re-emerged in recent years, compared with 40.6% in Henan and 23.8% in Liaoning. Less than 60% of participants thought current prevention and control programs had been effective. Participants believed mosquitoes in high abundance, imported cases and climate change were main risk factors for dengue in China. CONCLUSION: There were varying views of dengue in China. Professionals in areas susceptible to dengue were more likely to be concerned about climate change and dengue. Current prevention and control strategies need to be improved. Providing more information for staff in lower levels of Centers for Disease Control and Prevention may help in containing a possible increase of dengue.


Assuntos
Atitude do Pessoal de Saúde , Mudança Climática , Dengue/epidemiologia , Adulto , China/epidemiologia , Estudos Transversais , Demografia , Dengue/prevenção & controle , Feminino , Humanos , Masculino , Inquéritos e Questionários , Adulto Jovem
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