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1.
Eur Spine J ; 2023 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-36592207

RESUMO

PURPOSE: There is scarce information regarding the effectiveness of postoperative braces in decreasing mechanical complications and reinterventions following adult deformity surgery. METHODS: Retrospective matched cohort study from a prospective adult deformity multicenter database. We selected operated patients, fused to the pelvis, > 6 instrumented levels, and minimum 2 year follow-up. Three hundred and eighty patients were separated into two groups (Brace-3 months TLSO-vs No Brace) and then matched controlling for age, gender and frailty. We studied demographic, intraoperative, and postoperative spinopelvic parameters. Both groups were compared regarding complications and reinterventions in the first 2 postoperative years, using univariate and multivariate logistic regression analysis. RESULTS: We finally analyzed 359 matched patients, mean age of 65.3 ± 8.9 years, frailty-index (0.43 ± 0.15), and mostly females (84%). 224 patients wore a postoperative brace (B) and 135 didn't (NoB). They showed no difference in intraoperative variables and postoperative spinopelvic alignment. They differed (P < 0.05) in: Pelvic incidence (B:58° ± 13 vs NoB:54.5° ± 13); BMI (B:25.8 ± 4 vs NoB:27.4 ± 5); upper instrumented vertebra (B:81.7% T8-L1 vs NoB:72.6% T8-L1), and the use of multiple rods (B:47.3% vs NoB:18.5%). Univariate analysis showed a higher rate of mechanical complications and reinterventions when not using a brace. As well as higher NRS-back and leg pain at 6 weeks. However, multivariate analysis selected the use of multiple rods as the only independent factor protecting against mechanical complications (OR: 0.38; CI 95% 0.22-0.64) and reinterventions (OR: 0.41; CI 95% 0.216-0.783). CONCLUSION: After controlling for potential confounders, our study could not identify the protective effect of postoperative braces preventing mechanical complications and reinterventions in the first two postoperative years.

2.
Foot Ankle Orthop ; 8(1): 24730114221148165, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36654886

RESUMO

Background: Patients with neuromuscular diseases such as cerebral palsy (CP) are living longer because of advances in medicine, yielding a larger number of adult patients that could benefit from corrective surgery. However, some surgeons are hesitant to offer surgery to these patients because of concern for postoperative complications. A paucity of literature exists that describes complications in patients undergoing foot and ankle surgery for neuromuscular diseases. The primary study outcome was to identify the postoperative complication rates associated with foot and ankle surgery in adult patients with neuromuscular disease. Methods: The charts of patients with neuromuscular diseases who had foot and ankle surgery by the senior author at a single institution from March 2010 to March 2020 were reviewed. Patient charts were reviewed for demographic data, medical history and diagnoses, and surgical treatment information. Only patients' index procedures with the senior author were evaluated for surgical data. Patient charts were assessed to determine the presence or absence of a postoperative complication following an index procedure. Results: In a cohort of 42 patients, females comprised 60% of the patient cohort. The average age was 35 (range, 20-69) years old. CP was the most common neuromuscular diagnosis at 52% (22 of 42) patients. Eighteen percent (11 of 60) of the index surgeries had 1 or more complication with a total of 13 complications. The overall wound complication rate was 10% (6 of 60), infection rate was 8% (5 of 60), and the nonunion rate following arthrodesis was 10% (2 of 21). Conclusion: We conclude that foot and ankle surgery in this complex population can be done safely, with postoperative complication rates similar to the average population. Although these patients may present with unique challenges, surgeons should not forgo surgery out of concern for postoperative complications. Level of Evidence: Level IV, retrospective cohort study at a single institution.

3.
Cureus ; 15(1): e33729, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36655154

RESUMO

Acute lymphoblastic leukemia (ALL) is a group of hematological malignancies most commonly seen in pediatrics. The disease process localizes in lymphoid organs, the central nervous system, the mediastinum, and bone marrow (BM). The clinical features of T-cell acute lymphoblastic leukemia (T-ALL) in adults include evidence of generalized lymphadenopathy, hepatosplenomegaly, immunosuppression, and hypercalcemia. There is limited research on the efficacy of using modified pediatric treatment regimens in the elderly over the age of 60 with ALL; this case report aims to illustrate the successful treatment of a 67-year-old male patient diagnosed with T-ALL, using a modified Children's Oncology Group (COG) protocol. Through this, it has been shown to be an effective, safe, and efficacious treatment option for our patient.

5.
Int Orthod ; 21(1): 100724, 2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36657213

RESUMO

New possibilities such as Surgery-first and Minimal Presurgical Orthodontics have become extra alternatives for patients, orthodontists, and oral and maxillofacial surgeons, with immediate facial improvements, reduced preparation time, and shorter treatment time. The purpose of this case report was to demonstrate the retreatment of a female patient, dissatisfied with the instability of the compensatory orthodontic treatment, chin deviation, and forward inclination of the maxillary incisors, which was successfully treated with Minimal Presurgical Orthodontic approach associated with customized lingual brackets and virtual planning on the open-source Blender 3D software, where the post-surgical maxillary lingual brackets were also designed. Orthodontic preparation was performed in 5 months. After surgery, orthodontic treatment was finished with the aid of mini-implants and miniplates. The total treatment time was 18 months. Great facial and occlusal results were obtained and the patient was satisfied. Overall, all treatment steps were performed following a digital workflow and open-source software. It is possible to conclude that Minimal Presurgical Orthodontic Preparation was an excellent alternative for the retreatment of this patient with mandibular asymmetry and increased treatment expectations. Additionally, the surgical planning and design of lingual braces with open-source software can be considered useful and low-cost alternatives for orthodontists.

6.
Schizophr Res ; 252: 181-188, 2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36657362

RESUMO

BACKGROUNDS: This study explores the longitudinal changes and trajectories of cognitive functions in patients with adult-onset first-episode schizophrenia (FES) over four years and their relationships with the baseline subdomains of negative symptoms. METHODS: A total of 177 patients of age 25-55 with FES were recruited. Baseline demographics, clinical, social and cognitive functions were assessed. Diminished expression and diminished motivation of negative symptoms were assessed with Scale for the Assessment of Negative Symptoms (SANS). Patients had yearly follow-up of cognitive function assessments over four years. Latent class growth analysis (LCGA) and mixed linear regression model were used to explore the longitudinal changes of cognitive functions and the effect of baseline negative symptoms on the longitudinal cognitive function changes. Relationships of baseline negative symptoms subdomains and cognitive functions were also explored. RESULTS: Two trajectories of cognitive functions were identified. Longitudinal improvements were found in most cognitive functions apart from the logical memory. One trajectory of patients had significant deterioration of logical memory while the other group had significant improvement. Baseline diminished expression was associated with baseline and longitudinal changes of processing speed and verbal fluency while diminished motivation was associated with baseline and longitudinal changes of processing speed. CONCLUSIONS: Adult-onset FES patients had a homogeneous longitudinal improvement in most cognitive functions but not for logical memory suggesting the unique nature of verbal memory. The distinct relationship between baseline subdomains of negative symptoms with baseline and longitudinal cognitive functions suggesting the presence of differential overlapping etiology between negative symptom subdomains and cognitive functions.

7.
Omega (Westport) ; : 302228231153460, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36659817

RESUMO

Physical activity might be impact on death anxiety and loneliness in adult people. Accordingly, the present study examined loneliness and death anxiety in two groups of active and bedridden older men living in nursing homes in Yazd. This descriptive-analytical and cross-sectional study was conducted on older men living in nursing homes in Yazd, Iran. The participants were 148 older men who were randomly selected. The instruments used to collect the data were the Social and Emotional Loneliness Scale for Adults (SELSA-S) and the Death Anxiety Scale One-way ANOVA was also used. The findings indicated the active older men scored lower in loneliness and death compared to the bedridden older men. Loneliness and death anxiety are important psychological components that are more common in inactive older than their active counterparts. Therefore, physical activity in old age can improve older adults' quality of life.

8.
Artigo em Inglês | MEDLINE | ID: mdl-36661430

RESUMO

Youth engagement in institutional decision-making is necessary to ensure policy and practice is responsive and relevant to youth and community needs. In particular, it is critical to engage the voices and experiences of youth of Color who have historically been marginalized by healthcare organizations. The present study used multiple methods to examine youth and adult perspectives on the facilitators and barriers to implementing a citywide youth advisory board of youths of Color for a safety net hospital. Data were analyzed using thematic analysis. The findings illustrate the need to employ an antiracist framework to ensure organizational and adult readiness to engage youth of Color in an advisory board. Organizational readiness included assessing organizational culture, clear expectation setting, and creating safe spaces for youth. Adult readiness included adult facilitators who are trained in antiracist and equity-focused practice and the youth-adult partnership model, and a recognition of the bidirectional benefits of youth engagement in decision-making. The implications and recommendations of this study are timely given the historical mistrust between healthcare organizations and communities of Color, as well as the racial health inequities that have been further exposed during the COVID-19 pandemic.

9.
Childs Nerv Syst ; 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36662276

RESUMO

PURPOSE: Pilocytic astrocytoma is a slow-growing tumor that predominantly develops in children, but has a broad age spectrum. A notable characteristic of pilocytic astrocytoma is that the tumor arises in diverse locations and the clinical course is not always benign. Therefore, it is necessary to elucidate the clinical spectrum of the disease and analyze the relevant prognostic factors. METHODS: Demographic and treatment-related factors were retrospectively reviewed in a cohort of 254 patients with histologically confirmed pilocytic astrocytoma. Clinical features were compared between the pediatric group (N = 208; age < 18 years) and the adult group (N = 46; age ≥ 18 years). Cox regression analysis was performed to identify relevant prognostic factors. RESULTS: There was no difference in progression-free survival (PFS) between the pediatric and adult groups (p = 0.36); however, patients under 8 years of age exhibited worse PFS (p < 0.01). Leptomeningeal seeding at diagnosis and pilomyxoid histology was observed only in pediatric patients. In the pediatric group, nine patients experienced recurrence after complete resection. Increasing age (hazard ratio (HR) = 0.89, p < 0.01) and adjuvant therapy (HR = 0.32, p < 0.01) were protective factors against tumor progression. In the adult group, no progression occurred after complete resection. Age and adjuvant therapy were not significant factors in the adult group. CONCLUSION: Pilocytic astrocytoma presents with a diverse clinical spectrum. Complete resection is of utmost importance, and appropriate adjuvant treatment is recommended if complete resection cannot be achieved. Children with younger age are associated with more aggressive tumors, and recurrence may occur even after complete resection.

10.
BMC Infect Dis ; 23(1): 29, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653766

RESUMO

BACKGROUND: Broad and specific causes of adult mortalities are often neglected indicators of wellbeing in low-income countries like Ethiopia due to lack of strong vital statistics. Thus, this database study aimed to assess the causes of adult mortality using demographic surveillance data. METHODS: An 8-year (12 September 2009-11 September 2017) surveillance data from the Arba Minch Health and Demographic Surveillance Site was used for this study. Verbal autopsy methods and ICD codes were used to identify the causes of the adult deaths. The collected data were entered to the database by data clerks. We used Microsoft Excel and STATA version 16 software for data cleaning and analysis. Chi-squared test was used to see the significances of the trend analyses. RESULT: From the 943 adult deaths from 2009 to 2017 in the Health and Demographic Surveillance Site in southern Ethiopia, more than half of them were females. The specific leading cause of death in the adults were tuberculosis (16.8%), malaria (9.7%), and intestinal infectious diseases (9.6%). Communicable diseases (49.2%, 95% C.I 45.7, 52.7) accounted for about half of the deaths followed by non-communicable diseases (35%, 95% C.I 31.7, 38.4) where both categories showed an increasing trend. CONCLUSION: Although pieces of evidences are showing the shift from communicable diseases to non-communicable diseases as the major causes of adult death in developing countries, this study showed that communicable diseases are still the major causes of adult deaths. Efforts and emphasis should be given to control infectious diseases such as tuberculosis and malaria.


Assuntos
Doenças Transmissíveis , Malária , Doenças não Transmissíveis , Tuberculose , Feminino , Adulto , Humanos , Masculino , Causas de Morte , Seguimentos , Etiópia/epidemiologia , Mortalidade
11.
Int J Ophthalmol ; 16(1): 40-46, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36659939

RESUMO

AIM: To compare the effect of vegetable oils on the uptake of lutein and zeaxanthin by adult retinal pigment epithelial (ARPE)-19 cells in vitro. METHODS: ARPE-19 cells were cultured in Dulbecco's Modified Eagle Medium-F-12 supplemented with 10% foetal bovine serum and 1% penicillin-streptomycin in a humidified 5% CO2 incubator maintained at 37°C. Cells were treated with 247 µmol/L lutein, 49 µmol/L zeaxanthin and 1% (v/v) of either coconut oil, corn oil, peanut oil, olive oil, sunflower oil, soybean oil, castor oil, or linseed oil for 48h. Lutein and zeaxanthin concentration in the cells were quantified by high performance liquid chromatography. RESULTS: Among the oils tested, the highest lutein and zeaxanthin uptake was observed with coconut oil while the lowest was observed with linseed oil. CONCLUSION: ARPE-19 uptake of lutein and zeaxanthin are found to be dependent on the type of oils.

12.
Respir Med Case Rep ; 42: 101807, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36660069

RESUMO

Adult T-cell leukemia/lymphoma (ATLL) is a human T-cell leukemia virus type 1-inducing unevenly-distributed T-cell malignancy, which is often complicated by opportunistic infections. Here, we discuss the case of a 75-year-old woman presenting with Pneumocystis pneumonia (PCP) who was subsequently diagnosed with ATLL in Tokyo, a non-endemic area of ATLL. In addition to the elevated soluble interleukin-2 receptor and the detection of flower cells in the screening blood test, the high-resolution computed tomography findings, atypical of PCP, were clues to the diagnosis of ATLL. ATLL should be considered as an underlying disease when patients present with PCP, even in non-endemic areas.

13.
Int Orthod ; 21(1): 100726, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36669459

RESUMO

This case report describes a complex class II case with important maxillo-mandibular asymmetry in an adult patient treated with lingual straight-wire appliance. With the twofold aim of obtaining dramatic aesthetic improvement, since the patient refused surgical option, and ideal occlusal relationship, accurate set-up planification and biomechanical strategies with TADS for occlusal plane cant correction are needed to achieve the planned results. This case report demonstrates the possibility of solving successfully class II malocclusion with significant asymmetry in adult patient without surgery by means of an aesthetic appliance; on the other hand, it underlines the necessity of miniscrews and auxiliaries in order to obtain the best results.

14.
Diabetes Metab Res Rev ; : e3614, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36670050

RESUMO

AIMS: To investigate whether intermittently scanned continuous glucose monitoring without alarms (isCGM) improves glycemic control over capillary blood glucose monitoring (BGM) among adult type 1 diabetes mellitus (T1DM) patients with suboptimal control. MATERIALS AND METHODS: Adults with T1DM and HbA1c between 7% and 10% were 1:1 randomized to use isCGM or BGM for 24 weeks. The primary outcome was the change in HbA1c after intervention. The secondary outcomes were the change in sensor-derived metrics. RESULTS: A total of 104 adults with T1DM (34.2±12.2 years; M/F, 38/66) were randomized to isCGM group (n=54) and BGM group (n=50). After 24 weeks, HbA1c significantly decreased in isCGM group (8.1±0.7% to 7.5±1.0 %) and BGM group (8.0±0.8% to 7.7±1.0%), with between-group difference as 0.3% (95% CI, 0.0% to 0.6%; P=0.04). Percentage of HbA1c reduction over 1.0% and 1.5% was significantly higher in isCGM group, with adjusted odd ratios of 2.5 (95% CI: 1.1 to 5.5; P=0.03) and 3.2 (95% CI: 1.1 to 9.0; P=0.03). Mean time-in-range 70-180 mg/dL (TIR) in isCGM group significantly increased (from 58.5±13.0% to 63.0±12.6%), while mean TIR was similar in BGM group (from 58.0±14.6% to 57.5±14.5%). Time spent in hyperglycemia reduced more in isCGM group and time spent in hypoglycemia did not change significantly in both groups. CONCLUSION: Among adult T1DM patients with suboptimal glycemic control, compared with BGM, isCGM use resulted in a statistically significant improvement in glycemic control after 24-week intervention. This article is protected by copyright. All rights reserved.

15.
Eur Spine J ; 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36680618

RESUMO

PURPOSE: Adult spinal deformity (ASD) surgery carries a higher risk of perioperative systemic complications. However, evidence for the effect of planned two-staged surgery on the incidence of perioperative systemic complications is scarce. Here, we evaluated the effect of two-staged surgery on perioperative complications following ASD surgery using lateral lumbar interbody fusion (LLIF). METHODS: The study was conducted under a retrospective multi-center cohort design. Data on 293 consecutive ASD patients (107 in the two-staged group and 186 in the one-day group) receiving corrective surgery using LLIF between 2012 and 2021 were collected. Clinical outcomes included occurrence of perioperative systemic complications, reoperation, and intraoperative complications, operation time, intraoperative blood loss, transfusion, and length of hospital stay. The analysis was conducted using propensity score (PS)-stabilized inverse probability treatment weighting to adjust for confounding factors. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated in a PS-weighted cohort. RESULTS: In this cohort, 19 (18.4%) patients in the two-staged group and 43 (23.1%) patients in the one-day group experienced any systemic perioperative complication within 30 days following ASD surgery. In the PS-weighted cohort, compared with the patients undergoing one-day surgery, no association with the risk of systemic perioperative complications was seen in patients undergoing two-staged surgery (PS-weighted OR 0.78, 95% CI 0.37-1.63; p = 0.51). CONCLUSION: Our study suggested that two-staged surgery was not associated with risk for perioperative systemic complications following ASD surgery using LLIF.

16.
J Neurotrauma ; 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36680752

RESUMO

Mild traumatic brain injury (mTBI) affects 42 to 56 million individuals worldwide annually. Even more individuals are affected by sub-concussive repetitive head impacts (SRHI). Such injuries may result in significant acute and chronic symptoms. A study of how individuals may adjust or augment their nutritional and dietary habits to prevent cumulative neurotrauma and promote post-injury recovery is necessary. The objective of the current study is to systematically review nutritional and dietary interventions for neurotrauma prevention and mTBI recovery to direct clinical decision-making and identify future areas of research. This systematic, without a specified time-period, was performed in PubMed, Scopus, Cochrane, CINAHL and Web of Science followed by a manual search of references. Search strings were generated by a research librarian. Studies were included if: 1) investigate human subjects with mTBI or SRHI, 2) investigate a supplement/ingredient of dietary supplement sold in USA or dietary intervention without classification as a drug or prohibitive statement against use by FDA, 3) assess a quantifiable outcome, 4) be published in English in a peer-reviewed journal with an accessible full-length article. Exclusion if: 1) non-mTBI or SRHI subjects (e.g., moderate/severe TBI, stroke), 2) mTBI not assessed separately from moderate/severe mTBI, or 3) studies that required intracranial hemorrhage. A total of 15 studies from 12 unique subject populations met inclusion and exclusion criteria. 1,139 mTBI or SRHI subjects were enrolled across intervention arms in the study populations. A total of 8 intervention were studied. Omega-3 fatty acid (n-3FA), melatonin, and Pinus radiata were the only interventions examined in multiple studies. Studies included 10 randomized-control trials, three prospective observational studies, and two retrospective observational studies. Seven of the 15 studies had a low risk of bias. Eleven studies reported benefit of the intervention. Strongest evidence supports n-3FA utility for neurotrauma prevention in athletes exposed to SRHI. Both Pinus radiata and melatonin may have benefit for persistent post-concussion symptoms (PPCS), however additional multi-center studies are necessary prior to making a definitive conclusion on these supplements' efficacy. Future studies should continue to assess both novel interventions and additional interventions examined in this review to bring additional evidence to the burgeoning field of nutritional and dietary interventions for SRHI and mTBI.

17.
Epilepsia ; 2023 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-36622139

RESUMO

Familial adult myoclonus epilepsy (FAME) results from the same pathogenic TTTTA/TTTCA pentanucleotide repeat expansion in six distinct genes encoding proteins with different subcellular localizations and very different functions, which poses the issue of what causes the neurobiological disturbances that lead to the clinical phenotype. Postmortem and electrophysiological studies have pointed to cortical hyperexcitability as well as dysfunction and neurodegeneration of both the cortex and cerebellum of FAME subjects. FAME expansions, contrary to the same expansion in DAB1 causing spinocerebellar ataxia type 37, seem to have no or limited impact on their recipient gene expression, which suggests a pathophysiological mechanism independent of the gene and its function. Current hypotheses include toxicity of the RNA molecules carrying UUUCA repeats, or toxicity of polypeptides encoded by the repeats, a mechanism known as repeat-associated non-AUG translation. The analysis of postmortem brains of FAME1 expansion (in SAMD12) carriers has revealed the presence of RNA foci that could be formed by the aggregation of RNA molecules with abnormal UUUCA repeats, but evidence is still lacking for other FAME subtypes. Even when the expansion is located in a gene ubiquitously expressed, expression of repeats remains undetectable in peripheral tissues (blood, skin). Therefore, the development of appropriate cellular models (induced pluripotent stem cell-derived neurons) or the study of affected tissues in patients is required to elucidate how FAME repeat expansions located in unrelated genes lead to disease.

18.
BMJ Open ; 13(1): e061110, 2023 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-36653053

RESUMO

OBJECTIVES: To evaluate lung cancer (LC) risk factor awareness among Palestinians and identify factors associated with good awareness. DESIGN: Cross-sectional study. SETTINGS: Participants were recruited using convenience sampling from hospitals, primary healthcare centres (PHCs) and public spaces located at 11 governorates in Palestine. PARTICIPANTS: Of 5174 approached, 4817 participants completed the questionnaire (response rate=93.1%). A total of 4762 questionnaires were included: 2742 from the West Bank and Jerusalem (WBJ) and 2020 from the Gaza Strip. Exclusion criteria were working or studying in a health-related field, having a nationality other than Palestinian and visiting oncology departments or clinics at the time of data collection. TOOL: A modified version of the validated LC Awareness Measure was used for data collection. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was LC risk factor awareness level as determined by the number of factors recognised: poor (0-3), fair (4-7) and good (8-10). Secondary outcomes include the recognition of each LC risk factor. RESULTS: Smoking-related risk factors were more often recognised than other LC risk factors. The most recognised risk factors were 'smoking cigarettes' (n=4466, 93.8%) and 'smoking shisha (waterpipes)' (n=4337, 91.1%). The least recognised risk factors were 'having a close relative with LC' (n=2084, 43.8%) and 'having had treatment for any cancer in the past' (n=2368, 49.7%).A total of 2381 participants (50.0%) displayed good awareness of LC risk factors. Participants from the WBJ and the Gaza Strip had similar likelihood to display good awareness (50.6% vs 49.1%). Being≥45 years, having higher education and monthly income, knowing someone with cancer and visiting hospitals and PHCs seemed to have a positive impact on displaying good awareness. CONCLUSION: Half of study participants displayed good awareness of LC risk factors. Educational interventions are warranted to further improve public awareness of LC risk factors, especially those unrelated to smoking.


Assuntos
Árabes , Neoplasias Pulmonares , Humanos , Estudos Transversais , Fatores de Risco , Inquéritos e Questionários , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia
19.
BMJ Open ; 13(1): e066841, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36657760

RESUMO

INTRODUCTION: Haematopoietic stem cell transplant (HSCT) in adults is an intensive medical procedure for a variety of haematological malignancies. Although there is a large body of evidence demonstrating the negative effects of HSCT on physical function and psychosocial parameters, there is limited evidence on the impact of HSCT on body composition and bone health. Further, aerobic and resistance-training exercise interventions aimed at improving physical function and patient-reported outcomes largely take place during the peritransplant and post-transplant period. Prehabilitative exercise, or exercise prior to medical treatment, has been successfully deployed in presurgical candidates and other tumour sites, yet there is a paucity of evidence on the effect of prehabilitation in HSCT patients. The aim of this study is to investigate the feasibility, acceptability and safety of a resistance training exercise programme in patients with haematological malignancies prior to HSCT. METHODS AND ANALYSIS: IMpact of PRehabilitation in Oncology Via Exercise-Bone Marrow Transplant is a single-site, pilot randomised controlled trial of an exercise intervention compared with usual care. The primary aim is to assess the feasibility, acceptability and safety of the resistance-training exercise intervention prior to HSCT. Secondary aims include evaluating the differences in physical function, body composition, bone mineral density and patient-reported outcomes between the exercise group and usual care control group. Outcome measurements will be assessed: prior to HSCT, on/around day of HSCT admission, +30 days post-HSCT and +100 days post-HSCT. The exercise intervention is a home-based resistance training exercise programme that incorporates resistance band and body weight exercises. The primary outcomes will be reported as percentages and/or mean values. The secondary outcomes will be analysed using appropriate statistical methods to portray within-group and between-group differences. ETHICS AND DISSEMINATION: The study has Penn State College of Medicine approval. Results will be disseminated through scientific publication and presentation at exercise-related and oncology-related scientific meetings. TRIAL REGISTRATION NUMBER: NCT03886909.


Assuntos
Neoplasias Hematológicas , Transplante de Células-Tronco Hematopoéticas , Humanos , Adulto , Exercício Pré-Operatório , Projetos Piloto , Exercício Físico , Terapia por Exercício/métodos , Neoplasias Hematológicas/terapia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Clin Nutr ESPEN ; 53: 159-164, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36657908

RESUMO

BACKGROUND: Recent research has highlighted the beneficial effects of following a Mediterranean diet (MD) for depression. Unfortunately, adherence to specific diets presents many challenges and while previous research has aimed to understand these challenges, the focus has primarily been on weight-loss interventions in patients with obesity or cardiovascular disease. The aim of this study was to understand the experiences and challenges expressed by young men with clinical depression who completed a 12-week Mediterranean diet intervention. METHODS: An online questionnaire was used to collect data from 36 young Australian men aged between 18 and 25 with diagnosed depression who participated in the Mediterranean Diet arm of the Mediterranean Diet for Men with Depression (AMMEND) study. Descriptive analyses were undertaken for each variable with results reported as percentages and frequencies. RESULTS: Positive aspects highlighted by participants included enjoying the taste of foods, being highly motivated to continue with the diet and a perceived benefit to their depressive symptoms. The main challenges included increased cost and time commitment, and the negative attitudes of their friends and family towards the diet. CONCLUSION: We recommend that the influence of friends and family attitudes towards the diet and the impact this has on following a Mediterranean diet in young men be explored further, as this posed a challenge for many of our participants. These results may assist clinicians when promoting a Mediterranean diet to this specific demographic.


Assuntos
Depressão , Dieta Mediterrânea , Masculino , Humanos , Adolescente , Adulto Jovem , Adulto , Estudos Transversais , Austrália , Avaliação de Resultados da Assistência ao Paciente
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